PSP的影像學(xué)診斷課件

1、PSP的影像學(xué)診斷第1頁，共16頁。PSP（progressive supranuclear palsy) 診斷標(biāo)準(zhǔn)中年或中年后起病 ,進(jìn)行性非家族性核上性眼肌麻痹至少有下列 5 項(xiàng)中的 2項(xiàng):姿勢(shì)不穩(wěn) ,向后跌倒; 假性球麻痹(構(gòu)音障礙和吞咽困難) ; 少動(dòng)和強(qiáng)直; 額葉綜合征(智力遲鈍 ,強(qiáng)握和模仿動(dòng)作) ; 中軸肌張力異常和強(qiáng)直。以上癥狀非PSP特有，診斷還需要依靠影像學(xué)檢查，特別是MRI第2頁，共16頁。PSP的MRI診斷的幾個(gè)參數(shù)1 .T1 The superior profile of the midbrain(中腦上部輪廓）2 .T2 Midbrain global atroph

2、y （中腦整體萎縮）3 .T2 AP diameter of the midbrain at the level of the superior colliculus（中腦上丘水平前后徑）4 .T2 the presence of abnormal hyperintensity in the mesencephalic tegmentum（中腦被蓋異常高信號(hào)）5 .T2 Hypointensity in the posterolateral putamen（殼核后外側(cè)低信號(hào)）6 .T2 Hyperintensityin the posterolateral putamen第3頁，共16頁。Th

3、e superior profile of the midbrainA. Parkinson B.&C. PSP第4頁，共16頁。This sign is based on the observation that, in PSP, the atrophic midbrain (besides reduced AP diameter) shows a characteristic alteration in the normal convex profile of its superior surface, which tends to assume a flat or concave asp

4、ect on midline sagittal T1-weighted sections The Presence of abnormal superior profile of the midbrain had 68% sensitivity and 88.8% specificity. 第5頁，共16頁。Midbrain global atrophyIn PSP, the main abnormalities are in the midbrain. Midbrain atrophy is particularly well appreciated in the midsagittal M

5、RI section, which allows a direct comparison with the other segments of the brainstemThe sensitivity 68% and specificity 77.7%第6頁，共16頁。Axias ,T2-weighted spin-echo section show different degrees of midbrain atrophy第7頁，共16頁。第8頁，共16頁。AP diameter of the midbrain at the level of the superior colliculusT

6、he superior part of the quadrigeminal plate is often particularly thin; this finding correlates with the gaze abnormalities peculiar to these patients第9頁，共16頁。第10頁，共16頁。pons(A and B), midbrain (line 1, C and D), and quadrigeminal plate(line 2, A) on sagittal T1- andaxial T2-weighted magnetic resonan

7、ce imageswith the imagers internal distance measurement device.第11頁，共16頁。Patients with PSP showed significantly lower midbrain diameters than Patients with PD and MSA-P and control subjects(P.001)第12頁，共16頁。the presence of abnormal hyperintensity in the mesencephalic tegmentumAxial, 3-mm-thick, T2-we

8、ighted spin-echo sections show no abnormal tegmental hyperintensity (A) and abnormal tegmental hyperintensity (B, arrow).第13頁，共16頁。The presence of abnormal tegmental T2 hyperintensity had a sensitivity of 28% and a specificity of 100%. 第14頁，共16頁。Hypointensity and Hyperintensity in the posterolateral putamen are less frequently observed第15頁，共16頁。Summary1. The superior profile of the midbra