Usefulness of combined fractional anisotropy and apparent diffusion coefficient values for detection of involvement in multiple system atrophy
Usefulness of combined fractional anisotropy and apparent diffusion coefficient values for detection of involvement in multiple system atrophy
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DOI：
10.1136/jnnp.2006.104075
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发表时间：
2007-07-01
影响因子：
11
通讯作者：
Sobue, Gen
中科院分区：
文献类型：
--
作者：
Ito, Mizuki;Watanabe, Hirohisa;Sobue, Gen
目的：确定表观弥散系数（ADC）值和各向异性分数（FA）值是否可以检测多系统萎缩（MSA）的早期病理受累，并用于鉴别MSA-P（如果帕金森特征占主导地位，则为多系统萎缩）从帕金森病（PD）。我们比较了61例受试者的脑桥、小脑和壳核的ADC值和FA值（20例可能的MSA患者，21例年龄匹配的PD患者和20例年龄匹配的健康对照）使用3.0T磁共振系统。MSA组桥脑桥、小脑和壳核的ADC值显著高于PD组和对照组，FA值显著低于PD组和对照组。这些差异在缺乏背外侧壳核高信号（DPH）或热交叉结节（HCB）征的MSA中尤为突出。在区分MSA-P从PD使用FA和ADC值，我们得到了相同的敏感性（70%）和更高的特异性（100%），在脑桥比壳核和小脑。此外，所有在这三个区域中均具有显著低FA和高ADC值的患者均为MSA-P病例，而在脑桥中具有正常FA和ADC值的患者均为PD病例。我们的诊断算法的基础上，这些结果准确地诊断了90%的患者MSA-P。结论：FA和ADC值检测早期病理受累之前，磁共振信号的变化在MSA。特别是，脑桥中的低FA值在区分MSA-P与PD方面显示出高特异性。此外，联合分析所有三个区域的FA和ADC值比单独分析更有用。
Objective: To determine whether apparent diffusion coefficient ( ADC) values and fractional anisotropy ( FA) values can detect early pathological involvement in multiple system atrophy (MSA), and be used to differentiate MSA-P (multiple system atrophy if parkinsonian features predominate) from Parkinson's disease (PD).Methods: We compared ADC and FA values in the pons, cerebellum and putamen of 61 subjects (20 probable MSA patients, 21 age matched PD patients and 20 age matched healthy controls) using a 3.0 T magnetic resonance system.Results: ADC values in the pons, cerebellum and putamen were significantly higher, and FA values lower in MSA than in PD or controls. These differences were prominent in MSA lacking dorsolateral putaminal hyperintensity (DPH) or hot cross bun (HCB) sign. In differentiating MSA-P from PD using FA and ADC values, we obtained equal sensitivity (70%) and higher specificity (100%) in the pons than in the putamen and cerebellum. In addition, all patients that had both significant low FA and high ADC values in each of these three areas were MSA-P cases, and those that had both normal FA and ADC values in the pons were all PD cases. Our diagnostic algorithm based on these results accurately diagnosed 90% of patients with MSA-P.Conclusion: FA and ADC values detected early pathological involvement prior to magnetic resonance signal changes in MSA. In particular, low FA values in the pons showed high specificity in discriminating MSA-P from PD. In addition, combined analysis of both FA and ADC values in all three areas was more useful than only one.