A Fully Automated, Atlas-Based Approach for Superior Cerebellar Peduncle Evaluation in Progressive Supranuclear Palsy Phenotypes
A Fully Automated, Atlas-Based Approach for Superior Cerebellar Peduncle Evaluation in Progressive Supranuclear Palsy Phenotypes
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DOI：
10.3174/ajnr.a5048
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发表时间：
2017-03-01
影响因子：
3.5
通讯作者：
Quattrone, A.
中科院分区：
文献类型：
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作者：
Nicoletti, G.;Caligiuri, M. E.;Quattrone, A.
背景和目的：进行性核上性麻痹中小脑上脚受损。然而，理查森综合征进行性核上性麻痹和进行性核上性麻痹-帕金森综合征之间的改变有所不同。在本研究中，我们提出了一种用于评估小脑上脚完整性的自动化工具，并测试其在患有理查森综合征的进行性核上性麻痹、进行性核上性麻痹-帕金森病、帕金森病和健康对照患者中的表现。 材料和方法：对 21 名患有理查德森综合征的进行性核上性麻痹患者、9 名患有进行性核上性麻痹的患者进行了结构和扩散 MRI 扫描。麻痹性帕金森病、20 名帕金森病患者和 30 名健康受试者。在全自动流程中，首先使用基于纤维束成像的白质束图谱在 MR 成像上识别出左右小脑上脚；随后，从小脑上脚提取体积、平均扩散率和分数各向异性。对这些指标进行各组比较，并通过线性判别分析评估其区分患者的判别能力。 结果：与帕金森病患者和对照组相比，患有理查森综合征的进行性核上性麻痹患者的所有小脑上脚指标均发生改变（体积和分数各向异性减少，平均扩散率增加）。进行性核上性麻痹帕金森病患者的体积比帕金森病患者和对照患者小，各向异性分数比帕金森病患者低。与进行性核上性麻痹帕金森综合征患者相比，患有理查森综合征的进行性核上性麻痹患者左小脑上脚的分数各向异性和平均扩散率显着改变。仅使用显着变量的判别分析将进行性核上性麻痹-帕金森症与进行性核上性麻痹伴理查森综合征的准确率分别为 70%，将进行性核上性麻痹-帕金森症与帕金森病的准确率分别为 74%。 结论：我们证明了从健康受试者和帕金森病患者的小脑上脚提取多模态 MR 成像指标的自动化方法的可行性。我们提供的证据表明，小脑上脚的结构和扩散测量可能对于计算机辅助诊断进行性核上性麻痹亚型以及区分进行性核上性麻痹帕金森病患者和帕金森病患者有价值。
BACKGROUND AND PURPOSE: The superior cerebellar peduncle is damaged in progressive supranuclear palsy. However, alterations differ between progressive supranuclear palsy with Richardson syndrome and progressive supranuclear palsy-parkinsonism. In this study, we propose an automated tool for superior cerebellar peduncle integrity assessment and test its performance in patients with progressive supranuclear palsy with Richardson syndrome, progressive supranuclear palsy-parkinsonism, Parkinson disease, and healthy controls.MATERIALS AND METHODS: Structural and diffusion MRI was performed in 21 patients with progressive supranuclear palsy with Richardson syndrome, 9 with progressive supranuclear palsy-parkinsonism, 20 with Parkinson disease, and 30 healthy subjects. In a fully automated pipeline, the left and right superior cerebellar peduncles were first identified on MR imaging by using a tractography-based atlas of white matter tracts; subsequently, volume, mean diffusivity, and fractional anisotropy were extracted from superior cerebellar peduncles. These measures were compared across groups, and their discriminative power in differentiating patients was evaluated in a linear discriminant analysis.RESULTS: Compared with those with Parkinson disease and controls, patients with progressive supranuclear palsy with Richardson syndrome showed alterations of all superior cerebellar peduncle metrics (decreased volume and fractional anisotropy, increased mean diffusivity). Patients with progressive supranuclear palsy-parkinsonism had smaller volumes than those with Parkinson disease and controls and lower fractional anisotropy than those with Parkinson disease. Patients with progressive supranuclear palsy with Richardson syndrome had significantly altered fractional anisotropy and mean diffusivity in the left superior cerebellar peduncle compared with those with progressive supranuclear palsy-parkinsonism. Discriminant analysis with the sole use of significant variables separated progressive supranuclear palsy-parkinsonism from progressive supranuclear palsy with Richardson syndrome with 70% accuracy and progressive supranuclear palsy-parkinsonism from Parkinson disease with 74% accuracy.CONCLUSIONS: We demonstrate the feasibility of an automated approach for extracting multimodal MR imaging metrics from the superior cerebellar peduncle in healthy subjects and patients with parkinsonian. We provide evidence that structural and diffusion measures of the superior cerebellar peduncle might be valuable for computer-aided diagnosis of progressive supranuclear palsy subtypes and for differentiating patients with progressive supranuclear palsy-parkinsonism from with those with Parkinson disease.