目的 应用MR及MRS对原发性帕金森病脑萎缩和多系统萎缩进行对比分析,探讨二者的鉴别诊断.方法 12例原发性帕金森病和15例多系统萎缩患者给予常规MRI及1H-MRS检查,分析两组患者在常规MRI图像上的12项磁共振表现的阳性率的不同；比较两组患者脑组织的N-乙酰天门冬氨酸(NAA)、肌酸(Cr)、胆碱(Cho)含量的差异；最后比较两种检查方法对原发性帕金森病和多系统萎缩的诊断准确率的差异.结果 12项磁共振表现的幕上表现阳性率在两组患者间差异无统计学意义,P＞0.05,而幕下表现的阳性率两组间差异具有统计学意义,P＜0.05；1H-MRS检查结果显示差异具有统计学意义,P＜0.05；常规MRI检查对两种疾病的诊断准确率为81.48％ (22/27),1H-MRS检查的诊断准确率为92.59％ (25/27).结论 原发性帕金森病和多系统萎缩的常规MRI及1H-MRS表现均具有一定的特征性,但常规MRI鉴别两种疾病的准确率差于1H-MRS,1H-MRS鉴别诊断原发性帕金森病和多系统萎缩的应用价值高于常规MRI.%Objective To explore the differential diagnosis of idiopathic Parkinson's disease (IPD) and multiple system atrophy (MSA) by applying MRI and MRS. Methods Twelve patients of IPD (group A) and 15 patients of MSA (group B) were treated with conventional MRI and 1H-MRS. The difference in the positive rates of 12 MR findings on conventional MRI were analyzed; The levels of N-acetylaspartate (NAA), creatine (Cr), choline (Cho) in the brain tissue were compared between the two groups; The diagnostic accuracy of IPD and MSA by the two methods were compared. Results The positive rate of 12 MR findings showed no statistically significant difference between group A and group B (P>0.05), while the screen-positive rate showed statistically significant difference between the two groups (P<0.05). The diagnostic accuracy of the two diseases was 81.48% (22/27) for conventional MRI examination and 92.59% (25/27) for 'H-MRS, showing statistically significant difference (P<0.05). Conclusion The conventional MRI and 'H-MRS performance of idiopathic Parkinson's disease and multiple system atrophy have certain characteristics, but the diagnostic accuracy of 'H-MRS was better, thus having greater application value.
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