title: Morphometry MRI in the differential diagnosis of parkinsonian syndromes.
abstract: This study evaluates the diagnostic value of morphometric magnetic resonance imaging (MRI) in the differential diagnosis among Parkinson's disease (PD), progressive supranuclear palsy (PSP) and multiple system atrophy (MSA). We studied 21 PD cases, 11 MSA-c, 8 MSA-p and 20 PSP cases. Midbrain area (Ams), pons area (Apn), middle cerebellar peduncle (MCP) and superior cerebellar peduncle (SCP) were measured using MRI. Comparisons were made between PD, MSA-p, MSA-c and PSP. Apn, MCP and SCP morphometry dimensions presented differences among groups. Ams below 105 mm(2) and SCP smaller than 3 mm were the most predictive measures of PSP (sensitivity 95.0 and 80.0%, respectively). For the group of MSA-c patients, Apn area below 315 mm(2) showed good specificity and positive predictive value (93.8% and 72.7%, respectively). In conclusion, dimensions and cut off values obtained from routine MRI can differentiate between PD, PSP and MSA-c with good sensitivity, specificity and accuracy.
authors.affiliation: Department of Radiology, Sarah Network of Hospitals for Rehabilitation, Fortaleza, CE, Brazil. romuloggama@gmail.com
authors.forename: Rômulo L
authors.initials: RL
authors.lastname: Gama
authors.forename: Daniel F G
authors.initials: DF
authors.lastname: Távora
authors.forename: Rodrigo C
authors.initials: RC
authors.lastname: Bomfim
authors.forename: Cruiff E
authors.initials: CE
authors.lastname: Silva
authors.forename: Veralice M de
authors.initials: VM
authors.lastname: Bruin
authors.forename: Pedro F de
authors.initials: PF
authors.lastname: Bruin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008636:Mesencephalon / Q000473:pathology*; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000175:diagnosis* / Q000473:pathology; D010300:Parkinson Disease / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013494:Supranuclear Palsy, Progressive / Q000175:diagnosis* / Q000473:pathology