The morphometric parameters in MRI for differentiation progressive supranuclear Palsy from Parkinson's disease, multiple system atrophy and controls

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1 The morphometric parameters in MRI for differentiation progressive supranuclear Palsy from Parkinson's disease, multiple system atrophy and controls Poster No.: B-1322 Congress: ECR 2017 Type: Scientific Paper Authors: E. Ayd#n 1, C. Eraslan 1, A. Acarer 1, E. Akyuz 2, Z. Colakoglu 1, C. Keywords: DOI: Calli 1, O. Kitis 1 ; 1 #zmir/tr, 2 Ayd#n/TR CNS, Neuroradiology brain, MR, Screening /ecr2017/B-1322 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 11

2 Purpose Magnetic resonance parkisonism index (MRPI) has been proposed as a sensitive marker to differentiate progressive supranuclear palsy (PSP) from Idiophatic Parkinson's disease (IPD), multiple system atrophy (MSA) and controls (C). The cerebral peduncle angle is also a simple and reproducible measurement in predicting the clinical evolution in PSP patients like MRPI. The aim of this study was to evaluate the accuracy of MRPI and cerebral peduncle angle compared with the other MRI measurements, in distinguishing PSP from IPD, MSA and C groups. Page 2 of 11

3 Methods and materials Nine PSP patients, 8 MSA patients, 6 IPD patients, and 7 control subjects underwent MRI and, for each patient the pons area-midbrain area ratio (P/M) and MCP width-scp width ratio (MCP/SCP) were used, and an index termed MR parkinsonism index was calculated [(P/M) _ (MCP/SCP)] and also the cerebral peduncle angle, that is, the angle between the two cerebral peduncles was measured. Differences in MR imaging measurements among groups were evaluated with Tukey HSD, Kruskal-Wallis test and Bonferroni correction. Page 3 of 11

4 Images for this section: Fig. 1: Fig. 1. Schematic diagram of midsagittal (A) image of the brain and parasagittal and coronal (C) T1-weighted volumetric magnetic resonance (MR) images. A: The midbrain area (Oba M) and the pons area (Oba P) were measured using a standard line as described by Oba et al. 268 Copyright 2015 Korean Neurological Association Page 4 of 11

5 Fig. 2: B: The middle cerebellar peduncle length measured in a parasagittal image is marked with an asterisk (*). C: Bilateral superior cerebellar peduncle lengths are marked by arrows (#). 268 Copyright 2015 Korean Neurological Association Page 5 of 11

6 Fig. 3: D: The axial MR image shows cerebral peduncle angle as angle measured between medial aspects of cerebral peduncles with posteriormost midline point representing vertex of angle. This measurement is obtained in axial plane parallel to anterior commissure-posterior commissure line and located below level of mammillary bodies Fatterpekar et al. Page 6 of 11

7 Fig. 4: E: The axial length of the midbrain tegmentum, adjusted according to the anterior commissure-posterior commissure 268 Copyright 2015 Korean Neurological Association Page 7 of 11

8 Results P/M and MCP/SCP were larger in patients with PSP than in patients in MSA, IPD and C groups. MRPI index value was significantly larger in patients with PSP (median, 17,75; P<.001), than patients with IPD (median, 7.42; P<.001), and control participants (median, 9.73; P <.001). The cerebral peduncle angle measurements were (SD, 6.03 ) in PSP patients, (SD, 7.43 ) in C group, (SD, 1.15 ) in patients with MSA, and (SD, 2.07 ) in patients with PD. MRPI and cerebral peduncle angle measurement showed higher accuracy to distinguish PSP from other groups (100% sensitivity). Page 8 of 11

9 Conclusion MRPI and the cerebral peduncle angle are useful criterion for differentiating patients with PSP from IPD, MSA patients and healthy persons. Page 9 of 11

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