Multiple system atrophy:clinical manifestations and imaging characteristics / 中华神经科杂志

ABSTRACT

Objective To analyze the clinical manifestations as well as correlation between clinical manifestations and the new neuroimage characteristics(pontine"cross sign"and"putaminal slit")for correct diagnosis of multiple system atrophy(MSA).Methods Eleven patients with MSA based on Gilman diagnostic criteria were retrospectively analyzed for clinical manifestations and brain MRI findings.Results Eleven patients were probably diagnosed as MSA,among which 8 patients were MSA-C(olivopontoeerebellar atrophy,OPCA),2 patients were MSA-P(striatonigral degeneration,SND),one patient was MSA-A(Shy- Drager syndrome,SDS).Five years after onset,MRI of MSA-A showed stage 0"cross sign"and "putaminal slit".In 8 patients with MSA-C,2 patients reached stage Ⅰ 3 years after onset,one patient reached stage Ⅱ 2 years after onset,3 patients respectively did stage Ⅲ 1 year,3 years,and 5 years after onset,2 patients reached Ⅳ stage 2 years,and 7 years after onset respectively.As for putaminal slit,all of these patients were in stage 0.One patient with MSA-P reached stage 0"cross sign"and stage Ⅰ "putaminal slit"6 years after onset;another patient showed stage Ⅳ"cross sign"and stage Ⅱ"putaminal slit"9 years after onset,which was high slit intensity on both sides,however much stronger in the fight side than in the left side.Conclusion Both"cross sign"and"putaminal slit"are neuroimage characteristics for early diagnosing MSA-C,while"putaminal slit"for MSA-P.