Eur Radiol: With regard to multi-system atrophy, is it too late to make a diagnosis by "cross-bread"?!

In neuroimaging, the "cross bread" sign is a very typical neurodegenerative imaging sign, do you know what kind of disease typical MRI performance? As a neurologist or imaging doctor, is it enough to diagnose multi-system atrophy (MSA) with these signs? Maybe knowing this is not enough! Because of these signs, the modern medical level of patients' quality of life and survival can not be changed very little, and the existing treatment plan is often poor, there is no effective neuro protective treatment measures to improve and delay the development of the disease.
how can we make early and accurate diagnosis and identify diagnosis, find the signs of progression of the disease to evaluate the patient prognosis and evaluation for follow-up clinical research is the most basic magic weapon to benefit patients! MSA is an aggressive neurodegenerative disease characterized by involuntary movement, cerebral disorders, tremor paralysis and cone beam symptoms, with a incidence rate of about 1.9%-4.9%.
ISA is an incurable disease that usually dies 7-9 years after clinical symptoms.
there are two clinical subsypes of MSA: MSA (MSA-C), which is dominated by cerebral palsy, and MSA (MSA-P), which is dominated by tremor paralysis.
there is no effective way to judge the diagnosis of MSA, especially in the early stages of the disease.
how to identify high-risk groups of MSA early and quantitatively evaluate the severity of MSA is very urgent.
, a paper published on Eur Radiol called Magnetic resonance T1w/T2w ratio in the middle cerebellar peduncle may be a sensitive biomarker for multiple system atrophy using myelin-sensitive MrI contrast agents and standardized T1 weighted/T2 weighted (sT1w/T2w) ratios were used to quantitatively assess early changes in the mid-brain foot (MCP) in patients with msA-C.
the study included 28 MSA-C patients, including 17 MSA-C patients and 28 healthy controls within 2 years of onset (early MSA-C).
use 3T MR for T1w and T2w image acquisition.
used SPM12 to analyze the size of the ST1w/T2w ratio in the MCP area of interest, to evaluate the ability to identify MSA-C, early MSA-C subgroups and healthy volunteers using the MCP ST1w/T2w ratio, and to analyze the relevance of the MCPS ST1w/T2w ratio to other clinical parameters (ICARS scale, etc.).
1. A schematic study of the feet of the two-sided microcephaly showed that the MCPsT1w/T2w ratio was significantly lower than that of the healthy control group in all MSA-C patients (p-lt;0.001) and 17 early-stage (p-lt;0.001) MSA-C patients.
MCP sT1w / T2w ratio has a high sensitivity (96%) and specificity (100%) in distinguishing MSA-C from the control group (under-curve area: 0.99);
addition, in the early MSA-C group, the MCP sT1w/T2w ratio was highly relevant to the ICARS score.
Figure 2. The MCP sT1w / T2w ratio is shown in diagnostic efficacy graph 3. The results of the correlation analysis of MCP sT1w/T2w ratio with ICARS score show that the sT1w/T2w ratio can identify MSA-C-related changes in MCP at an early stage and may serve as a sensitive biomarker for the detection and diagnosis of MSA-C.
written later: the ultimate goal of imaging diagnosis is service and clinical.
imaging diagnosis is also worthless when it does not help clinical decision-making or clinical benefits.
the results of this study can diagnose or rule out the existence of multi-system atrophy at an early stage, which is undoubtedly very important for timely clinical supervision, and quantitative evaluation can effectively use digital speech to evaluate prognosis!