Differentiation Between Multiple System Atrophy and Other Spinocerebellar Degenerations Using Diffusion Kurtosis Imaging
Differentiation Between Multiple System Atrophy and Other Spinocerebellar Degenerations Using Diffusion Kurtosis Imaging
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DOI：
10.1016/j.acra.2018.12.015
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发表时间：
2019-11-01
影响因子：
4.8
通讯作者：
Sasaki, Makoto
中科院分区：
文献类型：
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作者：
Ito, Kenji;Ohtsuka, Chigumi;Sasaki, Makoto
理由和目的：多系统萎缩（MSA）和其他表现为小脑共济失调的脊髓小脑变性之间的鉴别往往是困难的。因此，我们研究磁共振扩散峰度成像（DKI）是否可以检测这些患者发生的病理变化并用于鉴别诊断。方法：三十六科（12例MSA患者伴有主要小脑共济失调[MSA-C]，10例脊髓小脑共济失调[SCA]或病因不明的散发性成人发作共济失调[SAOA]，和14名健康对照者）使用1.5T或3 T磁共振扫描仪进行检查。根据DKI数据，自动测量桥脑交叉束（PCT）、小脑中脚和小脑的平均峰度、各向异性分数和平均扩散率值，并计算与胼胝体值的比值。结果：我们发现PCT和小脑中脚的平均峰度和各向异性分数比率显著降低，与SCA/SAOA组和对照组相比，MSA-C组PCT的平均扩散率显著增加（p < 0.027-0.001）。在这些指标中，诊断性能没有显著差异。与之相反，小脑中的DKI比值在MSA-C组和SCA/SAOA组之间无显著性差异，但与对照组相比有显著性改变（p < 0.001）。结论：定量DKI分析可用于区分MSA-C和SCA/SAOA患者。
Rationale and Objective: Differentiation between multiple system atrophy (MSA) and other spinocerebellar degenerations showing cerebellar ataxia is often difficult. Hence, we investigated whether magnetic resonance diffusion kurtosis imaging (DKI) could detect pathological changes that occur in these patients and be used for differential diagnosis.Methods: Thirty-six subjects (12 patients with MSA accompanied by predominant cerebellar ataxia [MSA-C], 10 patients with spinocerebellar ataxias [SCAs] or sporadic adult-onset ataxia of unknown etiology [SAOA], and 14 healthy controls) were examined using 1.5- or 3-T magnetic resonance scanners. From the DKI data, the mean kurtosis, fractional anisotropy, and mean diffusivity values of the pontine crossing tract (PCT), middle cerebellar peduncle, and cerebellum were automatically measured, and the ratios against the values of the corpus callosum were calculated.Results: We found significant decreases in mean kurtosis and fractional anisotropy ratios in the PCT and middle cerebellar peduncle, and a significant increase in the mean diffusivity ratio in the PCT in the MSA-C group, as compared with the SCA/SAOA and control groups (p < 0.027-0.001). Among these metrics, there were no significant differences in the diagnostic performance. By contrast, the ratios in the cerebellum showed no significant differences between the MSA-C and SCA/SAOA groups but were significantly altered when compared with the controls (p < 0.001).Conclusion: Quantitative DKI analyses can be used to differentiate between patients with MSA-C and those with SCA/SAOA.