磁敏感加权成像鉴别多系统萎缩与特发性帕金森病的初步研究  

Preliminary study of susceptibility-weighted imaging in differentiation of multiple system atrophy and idiopathic Parkinson disease

作　　者：冯逢[1] 有慧[1] 胡凌[1] 王含[2] 郑福玲[1] 金征宇[1] 崔丽英[2] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院放射科,北京100730 [2]中国医学科学院中国协和医科大学北京协和医院神经科,北京100730

出　　处：《中国医学影像技术》2007年第6期781-784,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金资助(30670608)

摘　　要：目的评价磁敏感加权成像(SWI)在多系统萎缩与帕金森病的鉴别诊断中的作用。方法17例多系统萎缩患者和19例帕金森病患者在3.0T磁共振成像系统上行3mm层厚的快速自旋回波T2加权像和三维磁敏感加权成像覆盖纹状体。两名放射科专业医师在不知道患者临床诊断的情况下评价两个序列上苍白球和壳核的信号变化,背外侧壳核的信号等于或低于苍白球的信号作为两种疾病影像鉴别诊断的主要指标。应用χ2检验对两个序列发现异常的结果进行比较。结果15例多系统萎缩患者在磁敏感加权成像上发现壳核异常低信号(敏感性88.2%),而只有11例在薄层快速自旋回波T2加权像上发现异常(敏感性64.7%);3例帕金森病患者在磁敏感加权成像上发现壳核异常低信号(特异性84.2%),1例在薄层快速自旋回波T2加权像上发现异常(特异性94.7%)。结论SWI是一个评价运动障碍疾患脑内铁异常沉积的有价值的序列,进一步定量评价铁沉积强度及容积的研究有助于更好地鉴别帕金森综合征。Objective To evaluate the role of susceptibility-weighted imaging （SWI） in the differential diagnosis of multiple system atrophy （MSA） and idiopathic Parkinson disease （IPD）. Methods Axial 3 mm thick FSE T2WI and 3D SWI were performed at the level of striatum in 17 patients with MSA and 19 patients with IPD by using a 3.0T MR scanner. The signal drop at globus pallidus and putamen on two sequences were evaluated by two neuroradiolgists who did not know the clinical features of the patients. A hypointensity in the dorsolateral putamen equal to or lower than that in globus pallidus was taken into account as the main clue to differentiate the two diseases. Chi-square test was used to compare SWI findings with FSE T2WI findings in the diagnosis of MSA, Results Abnormal putaminal hypointensity was found in 15 of 17 patients with MSA （88.2% sensitivity） on SWI, while only 11 MSA patients showed abnormal putaminal hypointensity on FSE T2WI （64.7% sensitivity）. Three of 19 patients with IPD showed abnormal putaminal hypointensity （84.2%specificity） on SWI, while only 1 IPD patient showed abnormal putaminal hypointensity （94.7 % specificity） on FSE T2WI. Although there was no statistical significance in detection of abnormal putaminal hypointensity between SWI and thin-slice FSE T2WI （P= O. 225〉0.05）, 3D SWI allowed a better depiction of mild abnormalities in putamen. Conclusion SWI is a valuable sequence in evaluating iron deposition in movement disorders. Further study on quantifying the intensity and volume of the iron deposition may be helpful in the differential diagnosis of parkinsonism.

关 键 词：多系统萎缩 特发性帕金森病 磁敏感加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R745.1[医药卫生—诊断学]