MRI Planimetry and Magnetic Resonance Parkinsonism Index in the Differential Diagnosis of Patients with Parkinsonism

Differential diagnosis of multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration from Parkinson disease on clinical grounds is often difficult. MR imaging biomarkers could assist in a more accurate diagnosis. We examined the utility of MR imaging surface measurements...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2018-06, Vol.39 (6), p.1047-1051
Main Authors: Constantinides, V C, Paraskevas, G P, Velonakis, G, Toulas, P, Stamboulis, E, Kapaki, E
Format: Article
Language:English
Subjects:
Adult Brain
Atrophy
Biomarkers
Corpus callosum
Degeneration
Diagnosis
Differential diagnosis
Disease control
Magnetic resonance imaging
Medical imaging
Mesencephalon
Movement disorders
Neurodegenerative diseases
Paralysis
Parkinson's disease
Patients
Pons
Progressive supranuclear palsy
Resonance
Sensitivity
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Summary:Differential diagnosis of multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration from Parkinson disease on clinical grounds is often difficult. MR imaging biomarkers could assist in a more accurate diagnosis. We examined the utility of MR imaging surface measurements (MR imaging planimetry) in the differential diagnosis of patients with parkinsonism. Fifty-two patients with Parkinson-plus (progressive supranuclear palsy, = 24; corticobasal degeneration, = 9; multiple system atrophy, = 19), 18 patients with Parkinson disease, and 15 healthy controls were included. Corpus callosum, midbrain, and pons surfaces; relevant indices; and the Magnetic Resonance Parkinsonism Index were calculated. Corpus callosum subsection analysis was performed, and the corpus callosum posteroanterior gradient was introduced. A Magnetic Resonance Parkinsonism Index value of >12.6 discriminated progressive supranuclear palsy from other causes of parkinsonism with a 91% sensitivity and 95% specificity. No planimetry measurement could accurately discriminate those with multiple system atrophy with parkinsonism from patients with Parkinson disease. A corpus callosum posteroanterior gradient value of ≤191 was highly specific (97%) and moderately sensitive (75%) for the diagnosis of corticobasal degeneration versus all other groups. A midbrain-to-corpus callosum posteroanterior gradient ratio of ≤0.45 was highly indicative of progressive supranuclear palsy over corticobasal degeneration (sensitivity 86%, specificity 88%). MR imaging planimetry measurements are potent imaging markers of progressive supranuclear palsy and promising markers of corticobasal degeneration but do not seem to assist in the diagnosis of multiple system atrophy with parkinsonism.
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.A5618