目的:由于皮质基底综合征(CBS)的临床特征难以区分,皮质基底节变性(CBD)与其模拟物之间的生前区分仍然具有挑战性.然而,常规磁共振成像(MRI)在CBD诊断中的实用性尚未得到充分评估。这项研究旨在研究常规MRI发现在区分病理证实的CBD及其模拟物方面的诊断性能。
方法:采用半定量视觉评定量表评估常规T1加权和T2加权图像上萎缩和不对称的程度和分布。此外,视觉评估了流体衰减反转恢复图像上的皮质下白质高强度(SWMH)。
结果:除19例CBD患者外,16例具有CBD模拟物(进行性核上性麻痹(PSP):9,阿尔茨海默病(AD):4,路易体痴呆(DLB):1,额颞叶变性,TARDNA结合蛋白为43kDa(FTLD-TDP):1,并研究了球形胶质细胞tau病(GGT):1)。与CBD组相比,PSP-CBS亚组显示重度中脑萎缩,无SWMH.非PSP-CBS亚组,包括AD患者,DLB,FTLD-TDP,和GGT,表现出严重的颞部萎缩,具有广泛的不对称性,尤其是颞叶.除了超过一半的CBD患者,两个FTLD-TDP和GGT显示SWMH,分别。
结论:本研究基于视觉评定量表阐明了CBD及其模拟物之间的明显结构变化。对萎缩性分布和SWMH的评估可以用作常规MRI的成像生物标志物以检测背景病理。
OBJECTIVE: Due to the indistinguishable clinical features of corticobasal syndrome (CBS), the antemortem differentiation between corticobasal degeneration (CBD) and its mimics remains challenging. However, the utility of conventional magnetic resonance imaging (MRI) for the diagnosis of CBD has not been sufficiently evaluated. This study aimed to investigate the diagnostic performance of conventional MRI findings in differentiating pathologically confirmed CBD from its mimics.
METHODS: Semiquantitative visual rating scales were employed to assess the degree and distribution of atrophy and
asymmetry on conventional T1-weighted and T2-weighted images. Additionally, subcortical white matter hyperintensity (SWMH) on fluid-attenuated inversion recovery images were visually evaluated.
RESULTS: In addition to 19 patients with CBD, 16 with CBD mimics (progressive supranuclear palsy (PSP): 9, Alzheimer\'s disease (AD): 4, dementia with Lewy bodies (DLB): 1, frontotemporal lobar degeneration with TAR DNA-binding protein of 43 kDa(FTLD-TDP): 1, and globular glial tauopathy (GGT): 1) were investigated. Compared with the CBD group, the PSP-CBS subgroup showed severe midbrain atrophy without SWMH. The non-PSP-CBS subgroup, comprising patients with AD, DLB, FTLD-TDP, and GGT, showed severe temporal atrophy with widespread
asymmetry, especially in the temporal lobes. In addition to over half of the patients with CBD, two with FTLD-TDP and GGT showed SWMH, respectively.
CONCLUSIONS: This study elucidates the distinct structural changes between the CBD and its mimics based on visual rating scales. The evaluation of atrophic distribution and SWMH may serve as imaging biomarkers of conventional MRI for detecting background pathologies.