Dr. Paramita Hota presented at the European College of Radiology
Role of Qualitative and Quantitative parameters in Differentiation of Progressive Supranuclear Palsy from other Atypical Parkinsonian Syndromes in MRI.
Purpose: Overlapping atrophic features without specific radiological signs complicate the diagnosis of various atypical parkinsonian syndromes. A method of differentiating progressive systemic atrophy from other atypical parkinsonian syndromes with qualitative and quantitative measurement of midbrain volume loss is introduced.
Methods and Material: T1 midsagittal MRI image of 35 patients with clinically diagnosed PSP (n=6) MSA (n=4) DLB (n=2) CBD (n=3) and IPD (n=20) were acquired and measurements taken as depicted below.
Results: The absolute mid brain measurement (thick white line) and the mid brain to pons ratio were measured. Statistical significance of mid brain measurement < 9.35mm calculated from two columns and rows contingency table by Fisher exact probability test gives the P value that is < 0.001.
100% of clinically diagnosed MSA and PSP cases had a mid brain diameter measured as previously shown < 9.35mm. 100% of clinically diagnosed PSP cases show mid brain to pons ratio as described before < or = 0.52.
Conclusion: Mid brain to pons ratio < or = 0.52 is 100% specific for detection and differentiation of PSP from other atypical parkinsonian syndromes. This sign is reproducible, simple and correlates with other previously published results.