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| Value of MRI Combined with CTA or CT in Differentiating Vascular Parkinsonism from Idiopathic Parkinson's Disease |
| BA Jiwei1, WANG Huai1, YANG Xiaohua1, ZHANG Xiaojing2 |
1. Xuchang Wanrong Hospital of Traditional Chinese Medicine and Rehabilitation, Xuchang Henan 461000;
2. Xuchang Renhe Orthopedic Hospital, Xuchang Henan 461099 |
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Abstract 【Objective】 To explore the differential value of magnetic resonance imaging (MRI) combined with computed tomography angiography (CTA) or CT for vascular Parkinsonism (VP) and idiopathic Parkinson's disease (PD). 【Methods】 The clinical data of 50 patients with VP (VP group) and 50 patients with PD (PD group) treated in Xuchang Wanrong Hospital of Traditional Chinese Medicine and Rehabilitation from May 2021 to May 2023 were retrospectively analyzed. All patients underwent MRI, CT or CTA examinations. The width of the midbrain-pontine sulcus, midbrain diameter, and the ratio of midbrain-pontine sulcus width to midbrain diameter were compared between the two groups. Lesions in the subcortical white matter, basal ganglia and thalamus were also compared. Receiver operating characteristic (ROC) curve was adopted to analyze the diagnostic performance of MRI combined with CT or CTA for identifying VP. 【Results】 The midbrain-pontine sulcus width and the ratio of midbrain-pontine sulcus width to midbrain diameter in the PD group were lower than those in the VP group, with statistically significant differences (all P<0.05). No significant difference was found in midbrain diameter between the two groups (P>0.05). The detection rates of lesions in subcortical white matter, basal ganglia and thalamus in the VP group were higher than those in the PD group, and the differences were statistically significant (all P<0.05). ROC curve analysis showed that the area under the curve (AUC) of MRI was 0.799 with a Youden index of 0.497; the AUC of CTA or CT was 0.834 with a Youden index of 0.615; the AUC of MRI combined with CTA or CT reached 0.951, which was significantly higher than that of MRI alone and CTA or CT alone (all P<0.05). 【Conclusion】 MRI combined with CTA or CT possesses high clinical value in the differential diagnosis of PD and VP, which is worthy of clinical promotion.
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Received: 11 August 2025
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[1] 胡火有,韩漫夫,熊华花,等.经颅超声在诊断和鉴别诊断帕金森病中的应用及黑质回声与临床特征的关系研究[J].中国微侵袭神经外科杂志,2016,21(9):392-395.
[2] 莫俊宁,林均余,翁国媚.卒中高危因素与血管性帕金森综合征的相关性研究[J].黑龙江医药,2022,35(6):1383-1385.
[3] 许宇克.颅脑磁共振成像在帕金森病与血管性帕金森综合征鉴别诊断中的价值分析[J].临床医学工程,2019,26(8):1047-1048.
[4] He Y, Wang J G, Gao C Q. Validity of the diagnostic criteria for Parkinson's disease[J]. Lancet, 2024, 404(10453):652.
[5] 中华医学会神经病学分会帕金森病及运动障碍学组. 中国帕金森病的诊断标准(2016版)[J]. 中华神经科杂志, 2016, 49(4): 268-271.
[6] 中华医学会神经病学分会帕金森病及运动障碍学组, 中国医师协会神经内科医师分会帕金森病及运动障碍专业委员会. 中国血管性帕金森综合征诊断与治疗专家共识[J]. 中华神经科杂志, 2017, 50(5): 326-331.
[7] Brak H, Del Tredici K, Rüb U, et al. Staging of brain pathology related to sporadic Parkinson's disease[J]. Neurobiol Aging, 2003, 24(2): 197-211.
[8] 包才华,贺娟,舒意凯.PET/CT多巴胺受体显像早期诊断帕金森病的研究发展[J].中国实用神经疾病杂志,2021,24(18):1650-1656.
[9] Zijlmans J C, Daniel S E, Hughes A J, et al. Clinicopathological investigation of vascular parkinsonism, including clinical criteria for diagnosis[J]. Mov Disord, 2004, 19(6): 630-640.
[10] 王路路,林得乐,郁德波,等.KATP通道与帕金森病发病机制的研究进展[J].中外医疗,2023,42(5):190-193.
[11] 龚安娜,周佩洋,王勇,等.磁敏感加权成像序列下黑质小体-1信号强度值与帕金森病的临床相关性探讨[J].山西医药杂志,2021,50(18):2622-2625.
[12] Rektor I, Rektorova I, Kubova D, et al. An updated diagnostic approach to subtype definition of vascular parkinsonism: recommendations from an expert working group[J]. Parkinsonism Relat Disord, 2018, 49: 9-16.
[13] 冀学红,岳术义,李瑞莲,等.头颈部CTA、颈动脉彩超在老年血管性帕金森综合征与帕金森综合征中应用价值研究[J].脑与神经疾病杂志,2020,28(4):234-238.
[14] 吴明振,栾继昕,张传臣,等.黑质定量磁化率成像对帕金森病诊断价值的Meta分析[J].磁共振成像,2023,14(2):6-11. |
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2026, Vol. 43 
