Zina Z. Rozhkova PhD, DSc, Presenter: Nothing to Disclose

Irina N. Karaban PhD, Abstract Co-Author: Nothing to Disclose

Nicolas V Karaban' MD, Abstract Co-Author: Nothing to Disclose

Conventional MRI does not differentiate PD from MSA and PSP in the early stage of disease. We propose the relaxation times T2M of the main cerebral metabolites, and the ADC coefficients in the middle cerebral peduncles (MCP) for differentiation MSA from PD and PSP.

Four groups of patients are studied with 1.5T Signa Excite (GE). The PDG group includes 19 patients with PD, the MSAG group includes 16 patients with MSA, the PSPG group consists of 14 patients with PSP, and CG group includes 15 healthy volunteers. For all patients 1H spectra are obtained in basal ganglia (BG) and in MCP with SVSSTEAM: TR/TE=1500/144,164,184,204ms. From the echo-time dependence of AM (where AM are the peak areas of the signals from Cho, Cr and NAA the T2M are calculated. ADC coefficients are determined from EPI DWI: TR/TE=10/100ms, b=300,600,900s/mm2.

From comparison of T2M values in BG for patients of four groups the shortening of the T2M for patients are found. The mean T2M values (M = Cho, Cr, NAA) in BG are the following: in PDG (67.1, 40.5, 98.6 ms), in MSAG (145.2, 59.3, 207.5 ms), in PSPG (210.1, 185.3, 263.4ms), in CG (204.2, 198.0, 331.2 ms). These T2M differences allow us to distinguish subjects of CG from patients of MSAG, PDG, and PSPG, but they are not specific for differentiation of MSA from other diseases. The mean T2M values in MCP are the following: in PDG (63.3, 56.5, 90.2 ms), in MSAG (58.2, 49.0, 101.8 ms), in PSPG (134.1, 152.3, 233.1ms), in CG (215.0, 114.0, 320.1ms). The shortening of T2M in MCP for patients of MSAG is extremely specific. From analysis of DWI the ADC coefficients (in mm2/s) for patients of PDG, MSAG, PSPG, and CG in the region of BG are obtain: (0.65x10-3), (0.54x10-3), (0.64x10-3), and (0.44x10-3). More pronounce are differences of ADC in MCP: (0.82x10-3), (0.96x10-3), (0.79x10-3), and (0.81x10-3) in PDG, MSAG, PSPG, CG, respectively. Increasing of ADC coefficients in MCP for patients of the MSAG allows us differentiate MSA from PSP and PD with high sensitivity.

Detected in MCP significantly higher ADC, and also lower T2M in patients with MSA in comparison with patient with PD and PSP are in vivo diagnostic markers of MSA.

The DWI and relaxometry measurements in the BG allow us to discriminate patients from subjects of the CG, but did not differentiate patients of MSAG from PDG, and PSPG.

Rozhkova, Z, Karaban, I, Karaban', N, Quantitative Differentiation of Parkinsons Disease (PD), Multiple System Atrophy (MSA), and Progressive Supranuclear Palsy (PSP): In Vivo 1H MRS and DWI Study.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11003540.html