ADC值在鉴别多系统萎缩与帕金森病中价值

目的：探讨ADC值在鉴别多系统萎缩（MSA）与帕金森病（PD）中价值。材料与方法：对经临床诊断为MSA的14例,诊断为PD的15例患者和年龄匹配的15个正常人行常规磁共振和DWI扫描。DWI采用单次激发自旋回波—平面回波序列（TR 3000 ms,TE 90 ms）,兴趣区为两侧壳核、桥脑、小脑、小脑中脚和额叶白质区。结果：14例MSA中桥脑十字征有7例,延髓萎缩、桥脑萎缩及小脑萎缩的有10例,小脑中脚萎缩的10例。MSA组与PD组比较,壳核、桥脑、小脑及小脑中脚的ADC值较PD组均明显升高,P值均〈0.05。MSA组与正常对照组相比,壳核、桥脑、小脑及小脑中脚的ADC值也明显升高,P值均〈0.05。PD组和正常对照组相比,壳核、桥脑、小脑、小脑中脚和额叶白质区的ADC值差别均无统计学意义,三组的额叶白质区ADC值相比,差别无统计学意义（P〉0.05）。结论：MRI对MSA的诊断有一定的价值,小脑、小脑中脚、桥脑和壳核的ADC值对于这两种疾病的鉴别诊断有重要意义。

The Value of ADC Values in Differential Diagnosis Between Multiple System Atrophy and Parkinson's Disease

Purpose:To explore the value of ADC values in differential diagnosis between multiple system atrophy(MSA) and Parkinson disease(PD).Materials and Methods:Conventional MRI and DWI were performed in 14 clinically proved MSA patients,15 PD patients and 15 age-matched normal controls.DWI was performed using a single shot-spin echo-echo planar imaging sequences with TR/TE: 3000/90,The ROI′s is the bilateral putamen,pons,cerebellar,the middle cerebellar peduncles and cerebral white matter.Results:Of the 14 MSA patients,7 had hot-cross bun′sigh in the pons on T2-weighted images,10 patients had pontine,cerebellar and medulla oblongata atrophy,10 patients had atrophy of the middle cerebellar peduncles.ADC values in the putamen,pons,cerebellar and the middle cerebellar peduncles were significantly increased in the MSA group as compared to PD group(P<0.05).ADC values in the putamen,pons,cerebellar and the middle cerebellar peduncles were significantly increased in the MSA.group as compared to the control group(P<0.05).ADC values in the putamen,pons,cerebellar and the middle cerebellar peduncles were no significant difference in the PD group as compared to the control group(P>0.05).There was no significant difference in ADC values in the cerebral white matter.Conclusion:The routine MRI is helpful in differential diagnosis between MSA and PD.ADC values in the putamen,pons,cerebellar and the middle cerebellar peduncles had very important significance in differential diagnosis between MSA and PD.