title: Significance of apparent diffusion coefficient measurement for the differential diagnosis of multiple system atrophy, progressive supranuclear palsy, and Parkinson's disease: evaluation by 3.0-T MR imaging.
abstract: BACKGROUND
  The clinical differentiation of Parkinson's disease (PD) from multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) may be challenging, especially in their early stages. The aim of this study was to evaluate the utility of apparent diffusion coefficient (ADC) measurement to distinguish among these degenerative disorders.
  
  
  METHODS
  Twenty-five MSA, 20 PSP, and 17 PD patients and 18 healthy controls were retrospectively studied. Axial diffusion-weighted and T2-weighted images were obtained using a 3-T MR system. Regions of interest (ROIs) were precisely placed in the midbrain, pons, putamen, globus pallidus, caudate nucleus, thalamus, superior cerebellar peduncle, middle cerebellar peduncle, cerebellar white matter, and cerebellar dentate nucleus, and the regional ADC (rADC) value was calculated in each ROI.
  
  
  RESULTS
  In MSA, rADC values in the pons, middle cerebellar peduncle, cerebellar white matter, and cerebellar dentate nucleus were significantly higher than in PSP, PD, and controls. Furthermore, rADC values in the posterior putamen were significantly higher in MSA than in PSP and controls. In PSP, rADC values were significantly higher in the globus pallidus and midbrain than in MSA, PD, and controls. Furthermore, rADC values in the caudate nucleus and superior cerebellar peduncle were significantly higher in PSP than in MSA and controls. In PD, there were no significant differences in the rADC values compared to in MSA, PSP, and controls in all regions.
  
  
  CONCLUSIONS
  Evaluation of rADC values in characteristic lesions in MSA, PSP, and PD by placing ROIs using 3-T systems can provide useful additional information for differentiating these disorders.
authors.affiliation: Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, 36-1 Nishicho, Yonago 683-8504, Tottori, Japan.
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Tsukamoto
authors.forename: Eiji
authors.initials: E
authors.lastname: Matsusue
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Kanasaki
authors.forename: Suguru
authors.initials: S
authors.lastname: Kakite
authors.forename: Shinya
authors.initials: S
authors.lastname: Fujii
authors.forename: Toshio
authors.initials: T
authors.lastname: Kaminou
authors.forename: Toshihide
authors.initials: T
authors.lastname: Ogawa
mesh_terms: D000368:Aged; D001931:Brain Mapping / Q000379:methods; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000175:diagnosis* / Q000473:pathology; D010300:Parkinson Disease / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013494:Supranuclear Palsy, Progressive / Q000175:diagnosis* / Q000473:pathology