ATYPICAL PARKINSONISM

MSA-P

HYPOINTENSITY (SWI)

PUTAMEN LATERAL AND POSTERIOR PART

ATROPHY

PUTAMEN: SEEN IN BOTH MSA-C AND MSA-P

FLATTENING OF LATERAL PUTAMEN BORDER

HYPERINTENSITY (FLAIR/ T2)

LATERAL PUTAMEN BORDER

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PSP

MORNING GLORY:

MIDBRAIN TEGMENTUM ATROPHY

HYPERINTENSITY:

PONTINE TEGMENTUM

MIBDRAIN TECTUM

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PSP VS MSA

MID BRAIN/ PONS DIAMETER RATIO

PSP <0.52 

MSA >0.66

 

MIB BRAIN/ PONS AREA RATIO

NORMAL >0.24

PSP <0.22

MSA >0.29

 

MIB BRAIN AREA

PSP <107 

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PONS AREA

MSA <475 

 

NPH VS PSP

NPH CRITERIA:

MRHI <=0.58

MRHI = RATIO OF MAX COLLATERAL TRIGONES OF LATERAL VENTRICLES TO MAX INNER SKULL DIAMETER

SENSITIVITY 93% SPECIFICITY 100%

 

CALLOSAL ANGLE <= 84

SENSITIVITY 86% SPECIFICITY 91%

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