Comparison of magnetic resonance imaging in subtypes of multiple system atrophy

Lee, Eun Ah; Cho, Hyung In; Kim, Sam Soo; Lee, Won Yong

doi:10.1016/j.parkreldis.2004.04.008

Cited by 73 publications

(67 citation statements)

References 30 publications

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“…In the previous study, the FLAIR sequence was performed at a lower 1.0-tesla magnetic field strength, so the difference in the magnetic field strength, which affects the signal-to-noise ratio, was assumed to a reason for the higher sensitivity detected in our study. Contrary to the results of the present study, a previous study reported that FLAIR displayed low specificity for the diagnosis of MSA [26]. The reason for this was not discussed, but mild slit-like hyperintensity of the lateral putamen caused by age-related reactive gliosis might have caused this misinterpretation [6].…”

Section: Discussioncontrasting

confidence: 99%

“…In addition, in the present study, the subjects with a symptom duration shorter than 4 years tended not to display HPR on T2W sequences (false negativity rate: 57%, 8/14). Thus, the low sensitivity of T2W sequences for detecting HPR poses a diagnostic problem in spite of its higher specificity compared with other findings such as putaminal hypointensity [26,27]. However, in these studies, the presence of HPR was only evaluated on T2W sequences.…”

Section: Discussionmentioning

confidence: 99%

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Utility of the Fluid-Attenuated Inversion Recovery Sequence in Detecting a Hyperintense Putaminal Rim in Multiple System Atrophy-Parkinsonism: A Preliminary Study

Sakurai

Yamawaki²,

Okita³

et al. 2011

Eur Neurol

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Objective: To investigate the utility of fluid-attenuated inversion recovery (FLAIR) imaging for diagnosing multiple system atrophy-parkinsonism (MSA-P). Methods: We retrospectively evaluated 49 subjects (19 with MSA-P including 11 with early-stage disease, 15 with Parkinson’s disease and 15 matched controls) in order to compare the diagnostic value of FLAIR imaging to detect a hyperintense putaminal rim (HPR) with that of T₂-weighted (T2W) imaging. Results: Compared with T2W imaging, FLAIR imaging detected HPR more conspicuously in the 19 MSA-P patients (p = 0.01); this trend was also observed in 11 early-stage MSA-P patients (p = 0.01). Furthermore, FLAIR imaging tended to increase sensitivity of detecting HPR compared with T2W imaging (all patients: 89 vs. 58%, p = 0.07; early-stage patients: 100 vs. 55%, p = 0.06). Conclusions: FLAIR imaging might be more useful for detecting HPR in MSA-P patients, even though they are at an early stage.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Utility of the Fluid-Attenuated Inversion Recovery Sequence in Detecting a Hyperintense Putaminal Rim in Multiple System Atrophy-Parkinsonism: A Preliminary Study

Sakurai

Yamawaki²,

Okita³

et al. 2011

Eur Neurol

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“…2 ), atrophy of the cerebellum, and hyperintensity in the middle cerebellar peduncle (MCP) [38,43,[51][52][53] . When comparing MSA-P with MSA-C, putaminal abnormalities at 1.5 T seem to appear more often and earlier in MSA-P than MSA-C, and conversely infratentorial abnormalities seem to appear more often and earlier in MSA-C than in MSA-P [54][55][56] . Specificity of abnormalities to differentiate MSA from PD and healthy controls is considered quite high, whereas sensitivity -particularly in early disease stages -seems to be insufficient [38,53,54,57] .…”

Section: Summary Of the Mr-based Neuroimaging Studies In The Differenmentioning

confidence: 82%

“…When comparing MSA-P with MSA-C, putaminal abnormalities at 1.5 T seem to appear more often and earlier in MSA-P than MSA-C, and conversely infratentorial abnormalities seem to appear more often and earlier in MSA-C than in MSA-P [54][55][56] . Specificity of abnormalities to differentiate MSA from PD and healthy controls is considered quite high, whereas sensitivity -particularly in early disease stages -seems to be insufficient [38,53,54,57] . For instance, putaminal atrophy appears to specifically delineate MSA from PD, but T 2 putaminal hypointensity and a putaminal hyperintense rim may be observed in both diseases [55,[58][59][60] .…”

Section: Summary Of the Mr-based Neuroimaging Studies In The Differenmentioning

confidence: 82%

Significance of MRI in Diagnosis and Differential Diagnosis of Parkinson’s Disease

et al. 2010

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The differential diagnosis of parkinsonian syndromes is considered one of the most challenging in neurology, even for movement disorder specialists. Despite published consensus operational criteria for the diagnosis of Parkinson’s disease (PD) and the various atypical parkinsonian disorders (APDs) such as progressive supranuclear palsy, multiple system atrophy, and corticobasal syndrome, the clinical separation of APDs from PD carries a high rate of misdiagnosis. However, an early differentiation between APD and PD, each characterized by a largely different natural history, is crucial for determining the prognosis and choosing a treatment strategy. Despite limitations, the different modern magnetic resonance (MR) techniques have undoubtedly added to the differential diagnosis of neurodegenerative parkinsonism. Conventional MRI with visual assessment of T₂- and T₁-weighted imaging as well as various advanced MRI techniques offer objective measures and may therefore be useful tools in the diagnostic workup of PD and APDs. In clinical practice, conventional MRI is a well-established method for the exclusion of symptomatic parkinsonism due to other pathologies such as tumors, cerebral ischemia or inflammatory diseases. Furthermore, over the past two decades, advances in MR techniques have enabled to quantitatively illustrate abnormalities in the basal ganglia and infratentorial structures in APDs by methods such as magnetic resonance volumetry, diffusion-weighted imaging, magnetization transfer imaging and proton magnetic resonance spectroscopy. This article aims to review research findings on the value of MRI techniques in the differential diagnosis of neurodegenerative parkinsonian disorders.

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“…Other disorders associated with parkinsonism, such as Parkinson's disease with autonomic failure, progressive supranuclear palsy (PSP), and diffuse Lewy body disease (DLBD), may often be misdiagnosed as MSA-P [7,8,9,10,11,12]. A neuropathological study showed that Table 1.…”

Section: Discussionmentioning

confidence: 99%

MSA-C is the predominant clinical phenotype of MSA in Japan: Analysis of 142 patients with probable MSA

Yabe¹,

Soma²,

Takei³

et al. 2006

Journal of the Neurological Sciences

122

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We investigated the clinical features and mode of disease progression in 142 patients with probable multiple system atrophy (MSA) according to the Consensus Criteria. The subjects included 84 men and 58 women with a mean age at onset of 58.2 ± 7.1 years (range: 38-79 years). Cerebellar signs were detected in 87.3% of these patients at the time of initial examination, and were found in 95.1% of them at latest follow-up. MSA-C was diagnosed in 83.8% of the patients at their first examination.Parkinsonism was initially detected in 28.9% of the patients, increasing to 51.4% at the latest follow-up. Among all of the subjects, only 16.2% were classified as having MSA-P on initial examination. At the latest follow-up, parkinsonian features had become predominant over cerebellar features in 24.6% of the 65 patients with MSA-C who were followed for more than 3 years. Although parkinsonism usually masked the signs of cerebellar involvement in MSA-C patients, none of the patients with MSA-P at an early stage showed predominance of cerebellar features at the latest follow-up.Parkinsonism is the predominant feature of MSA among Western patients, even at an early stage, but this study showed that cerebellar deficits are the main feature in Japanese patients. This difference of disease manifestations between ethnic groups suggests that genetic factors may influence the clinical phenotype of MSA.

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Comparison of magnetic resonance imaging in subtypes of multiple system atrophy

Cited by 73 publications

References 30 publications

Utility of the Fluid-Attenuated Inversion Recovery Sequence in Detecting a Hyperintense Putaminal Rim in Multiple System Atrophy-Parkinsonism: A Preliminary Study

Utility of the Fluid-Attenuated Inversion Recovery Sequence in Detecting a Hyperintense Putaminal Rim in Multiple System Atrophy-Parkinsonism: A Preliminary Study

Significance of MRI in Diagnosis and Differential Diagnosis of Parkinson’s Disease

MSA-C is the predominant clinical phenotype of MSA in Japan: Analysis of 142 patients with probable MSA

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