New and reliable MRI diagnosis for progressive supranuclear palsy
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Abstract
Objective: To evaluate the area of the midbrain and pons on mid-sagittal MRI in patients with progressive supranuclear palsy (PSP), Parkinson disease (PD), and multiple-system atrophy of the Parkinson type (MSA-P), compare these appearances and values with those of normal control subjects, and establish diagnostic MRI criteria for the diagnosis of PSP.
Methods: The authors prospectively studied MRI of 21 patients with PSP, 23 patients with PD, 25 patients with MSA-P, and 31 age-matched normal control subjects. The areas of the midbrain tegmentum and the pons were measured on mid-sagittal MRI using the display tools of a workstation. The ratio of the area of the midbrain to the area of the pons was also evaluated in all subjects.
Results: The average midbrain area of the patients with PSP (56.0 mm2) was significantly smaller than that of the patients with PD (103.0 mm2) and MSA-P (97.2 mm2) and that of the age-matched control group (117.7 mm2). The values of the area of the midbrain showed no overlap between patients with PSP and patients with PD or normal control subjects. However, patients with MSA-P showed some overlap of the values of individual areas with values from patients with PSP. The ratio of the area of the midbrain to the area of pons in the patients with PSP (0.124) was significantly smaller than that in those with PD (0.208) and MSA-P (0.266) and in normal control subjects (0.237). Use of the ratio allowed differentiation between the PSP group and the MSA-P group.
Conclusion: The area of the midbrain on mid-sagittal MRI can differentiate PSP from PD, MSA-P, and normal aging.
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Letters: Rapid online correspondence
- Reply to Wszolek et al
- Hiroshi Oba, MD, Department of Radiology, Teikyo University, 2-11-1 Kaga, Tokyo-Itabashi, 1738605 Japanoba@med.teikyo-u.ac.jp
- Hitoshi Terada, MD, Second Department of Radiology (Dr. Terada), Toho University School of Medicine, Tokyo, Japan
Submitted September 14, 2005 - New and reliable MRI diagnosis for progressive supranuclear palsy
- Zbigniew K Wszolek, MD, FAAN, Department of Neurology, Mayo Clinic, 4500 San Pablo Road, 32224 Jacksonville, FLwszolek.zbigniew@mayo.edu
- Jerzy Slowinski, MD, Akiko Imamura, MD, Yoshio Tsuboi, MD, Daniel F Broderick (Jacksonville, FL)
Submitted September 14, 2005
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