Magnetic Resonance Imaging Biomarkers Distinguish Normal Pressure Hydrocephalus From Progressive Supranuclear Palsy
Magnetic Resonance Imaging Biomarkers Distinguish Normal Pressure Hydrocephalus From Progressive Supranuclear Palsy
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DOI：
10.1002/mds.28087
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发表时间：
2020-05-12
影响因子：
8.6
通讯作者：
Quattrone, Aldo
中科院分区：
文献类型：
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作者：
Quattrone, Andrea;Sarica, Alessia;Quattrone, Aldo
背景特发性正常压力脑积水和PSP有一些共同的临床和影像学特征，作出鉴别诊断，有时，challenging.Objectives区分特发性正常压力脑积水与PSP使用MR容积和线性measurements.Methods 27例特发性正常压力脑积水患者，103例可能的PSP患者，和43名对照组连续入组。使用Freesurfer 6在MR T-1加权图像上进行自动心室容积测定。线性测量，如胼胝体角和一个新的措施，称为MR脑积水指数，计算磁共振T-1加权图像。受试者操作特征分析用于区分患者组。结果的普遍性和再现性进行了验证，划分每个参与者组在两个队列中使用的培训和测试subset.Results心室体积和线性测量（胼胝体角和磁共振脑积水指数）显示更大的脑室扩大特发性正常压力脑积水患者比PSP患者和对照组。PSP患者的心室容积大于对照组。自动脑室容积测定和磁共振脑积水指数是区分特发性正常压力脑积水患者和PSP患者的最准确的测量方法（98.5%），而胼胝体角错误分类了几个PSP患者，在区分这两种疾病时显示出较低的阳性预测值（70.0%）。所有测量准确区分特发性正常压力脑积水患者与对照组。在训练集（自动心室容积测定，98.4%，磁共振脑积水指数，98.4%，胼胝体角，87.5%）中获得的准确度值被确认在testingset.Conclusions我们的研究表明，AVV和磁共振脑积水指数是最准确的措施区分特发性正常压力脑积水和PSP患者。磁共振脑积水指数易于测量，可用于临床实践，以防止误诊和无效的分流术在特发性正常压力脑积水模仿。(c)2020国际帕金森和运动障碍协会
Background Idiopathic normal pressure hydrocephalus and PSP share several clinical and radiological features, making differential diagnosis, at times, challenging.Objectives To differentiate idiopathic normal pressure hydrocephalus from PSP using MR volumetric and linear measurements.Methods Twenty-seven idiopathic normal pressure hydrocephalus patients, 103 probable PSP patients, and 43 control subjects were consecutively enrolled. Automated ventricular volumetry was performed using Freesurfer 6 on MR T-1-weighted images. Linear measurements, such as callosal angle and a new measure, termed MR Hydrocephalic Index, were calculated on MR T-1-weighted images. Receiver operating characteristic analyses were used for differentiating between patient groups. Generalizability and reproducibility of the results were validated, dividing each participant group in two cohorts used as training and testing subsets.Results Ventricular volumes and linear measurements (callosal angle and Magnetic Resonance Hydrocephalic Index) revealed greater ventricular enlargement in patients with idiopathic normal pressure hydrocephalus than in PSP patients and controls. PSP patients had ventricular volume larger than controls. Automated ventricular volumetry and Magnetic Resonance Hydrocephalic Index were the most accurate measures (98.5%) in differentiating patients with idiopathic normal pressure hydrocephalus from PSP patients, whereas callosal angle misclassified several PSP patients and showed low positive predictive value (70.0%) in differentiating between these two diseases. All measurements accurately differentiated idiopathic normal pressure hydrocephalus patients from controls. Accuracy values obtained in the training set (automated ventricular volumetry, 98.4%; Magnetic Resonance Hydrocephalic Index, 98.4%; callosal angle, 87.5%) were confirmed in the testing set.Conclusions Our study demonstrates that AVV and Magnetic Resonance Hydrocephalic Index were the most accurate measures for differentiation between idiopathic normal pressure hydrocephalus and PSP patients. Magnetic Resonance Hydrocephalic Index is easy to measure and can be used in clinical practice to prevent misdiagnosis and ineffective shunt procedures in idiopathic normal pressure hydrocephalus mimics. (c) 2020 International Parkinson and Movement Disorder Society