多系统萎缩的临床和影像学特征分析OA

Objective To investigate the clinical and radiological features of patients with different phenotypes of multiple system atrophy(MSA).Methods A total of 400 patients with MSA who attended the outpatient service or were hospitalized in Department of Neurology,Chinese PLA General Hospital,were enrolled,among whom there were 294 patients with MSA-cerebellar type(MSA-C)and 106 patients with MSA-Parkinsonian type(MSA-P).The t-test and the chi-square test were used to analyze the clinical manifestations,radiological features,and blood biochemical indicators of the two groups.Results As for clinical manifestations,there were significant differences in cerebellar symptoms,constipation,and Babinski sign between MSA-C patients and MSA-P patients(P<0.05).As for radiological features,positron emission tomography/computed tomography(PET/CT)showed that MSA-P patients had a typical reduction in DAT uptake in the putamen and the caudate nucleus,while magnetic resonance imaging showed that compared with the MSA-C group,the MSA-P group had a significantly higher proportion of patients with putamen fissure sign or white matter demyelination;for MSA-C patients,PET/CT showed cerebellar hypometabolism,and magnetic resonance imaging showed the cross sign and high signal intensity in the pontine arm,as well as a significantly higher proportion of patients cerebellar and pontine atrophy than MSA-P patients(P<0.05).As for laboratory markers,MSA-P patients had a significantly lower level of uric acid than MSA-C patients(P=0.029).Conclusion Patients with different subtypes of MSA have specific clinical features,radiological features,and uric acid level,which has a certain significance in the accurate diagnosis of MSA.