Differentiation of atypical parkinsonian syndromes with routine MRI.
OBJECTIVE
To evaluate the use of routine MRI in differentiating between patients with progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal degeneration (CBD) and control subjects.


METHODS
Two neuroradiologists rated blindly and independently axial T2-weighted and proton density MR images of 54 patients with MSA, 35 patients with PSP, 5 patients with CBD, and 44 control subjects.


RESULTS
More than 70% of patients with PSP and more than 80% of patients with cerebellar predominant MSA could be classified correctly with 0.5-T or 1.5-T scans, and no patient in these groups was misclassified. In the remaining patients an unequivocal differentiation could not be made. However, only approximately 50% of patients with parkinsonism-predominant MSA could be classified correctly, and 19% of them (all of whom had had 0.5-T scans) were misclassified.


CONCLUSIONS
Characteristic findings on routine MRI, either 1.5 T or 0.5 T, can contribute to the identification of MSA and PSP. However, in a minority of patients no unequivocal diagnosis can be made using MRI findings alone.
Schrag
A
A
Department of Clinical Neurology, Institute of Neurology, London, UK.
Good
C D
CD
Miszkiel
K
K
Morris
H R
HR
Mathias
C J
CJ
Lees
A J
AJ
Quinn
N P
NP
D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000473:pathology*; D012680:Sensitivity and Specificity; D013577:Syndrome