[Semiquantitative evaluation of cranial computerized tomography as diagnostic support in progressive supranuclear...

Different neuroimaging findings have been described in association with progressive supranuclear palsy (PSP), but their use as diagnostic support in this condition has been the subject of much discussion.

Three radiologists, non-specialists in neuroradiology and with no specific information regarding neuroimaging in Parkinson syndromes, analyzed (without knowing any clinical details) seven cranial CT in five patients diagnosed as probable PSP according to NINDS-SPSS criteria, nine with idiopathic Parkinson's disease, and six persons aged over 55 years who acted as controls. The radiologists were asked to assess 17 variables as absent, moderate or severe. The results were analyzed using the chi squared test for qualitative variables and Fisher's exact test when necessary.

The identification of the variables antero-posterior and transversal atrophy of the mid-brain, atrophy of the pons, enlargement of the perimesencephalic cisterns and the quadrigeminal plate and increased size of the third ventricle were considered to be statistically significant in the cases of PSP as compared with other observations. The small number of patients did not permit the establishment of correlation of statistical importance between the radiological parameters and clinical condition.

We present the point of view of non-specialist neuroimaging workers, in these patients. We found that there were six parameters of interest on cranial CT which permitted differentiation of cases of PSP, idiopathic Parkinson's disease and a control population. Four of these parameters did not appear to a severe degree in patients who did not have PSP. These results are partly comparable to those published in the literature.