The Value Of Conventional MRI And ~1H-MRS In Differential Diagnosis Between MSA And Idiopathic Parkinson's Disease

Objective To explore the value of routine MRI and ~1H-MR Sin differential diagnosis between MSA and IPD.Methods MRI features of 17 patients with MSA and 16 patients with IPD were retrospectively analyzed.And 16 age-matched healthy peoples were regarded as control.We performed ~1H-MRS sequences to all patients and 16 age-matched healthy control subjects.Multiple-voxel ~1H-MRS data were acquired using PRESS pulse sequence with TE=135 ms and TR=1500 ms.The spectroscopic regions of interest(ROI)were the bilateral putamen and pons with a 1.0 cm~3 spatial resolution.Results Among 10 MRI findings,infratentorial MRI findings were hot-cross bun' sigh,cerebellar atrophy,atrophy of the middle cerebellar peduncles,medulla oblongata atrophy,pontine atrophy and fourth ventricle dilatation.Supratentorital MRI findings were hyperintense rim of the putamen,putaminal hyperintensity and putaminal atrophy.However,Infratentorial MRI findings to identify the MSA and IPD were all statistically significant(P＜0.05).supratentorital MRI findings were not valid to differentiate MSA from IPD(P＞0.05).Among all MRI findings the highest sensitivity were cerebellar atrophy,medulla oblongata atrophy and atrophy of the middle cerebellar peduncles,The highest specificity were hot-cross bun' sigh and hyperintense rim of the putamen.The peak area ratios of NAA/Cr was significantly decreased in the patients with MSA compared to the patients with IPD in the bilateral putamen and pons(P=0.002,P=0.000).The peak area ratios of NAA/Cr was significantly decreased in the patients with MSA compared to the controls in the bilateral putamen and pons(P=0.000,P=0.000).The peak area ratios of Cho/Cr was significantly decreased in the patients with MSA compared to the patients with IPD andthe controls in the pons.The peak area ratios of NAA/Cr was significantly decreased(P=0.000)in the patients with IPD compared to the controls in the bilateral putamen.The peak area ratios of NAA/Cr and Cho/Cr had no significantly statistical significance in the patients with MSA compared to the patients with IPD and the controls in the bilateral cerebral white matter.Conclusions:The routine MRI is helpful in differential diagnosis between MSA and IPD.~1H-MRS provides assistance for differential diagnosis between MSA and IPD.