原发性单侧症状帕金森病SWI脑铁沉积的定量研究  

A susceptibility weighted imaging quantitative study of brain iron deposition in idiopathic Parkinson's disease

作　　者：王波[1] 马莎[1] 戴敏方[1] 安鸿飞[1] 王云勇[1] 张洁[1] 沈凌[2] 

机构地区：[1]昆明医科大学云南省第一人民医院,云南昆明650032 [2]昆明医学院健康研究所,云南昆明650031

出　　处：《中国临床医学影像杂志》2013年第4期234-238,共5页Journal of China Clinic Medical Imaging

基　　金：云南省科技厅-昆明医学院联合专项基金(2011FB218)

摘　　要：目的:通过比较原发性单侧症状帕金森病(Parkinson’s disease,PD)患者与正常对照组脑内多个结构的T2*值,定量分析PD患者T2*值的变化规律,探讨PD早期诊断的线索。方法:采用3.0T磁共振成像系统对24例原发性单侧症状PD患者组及24名年龄、性别相匹配的正常对照组进行常规序列及SWI序列的扫描。经后处理在T2*图上分别手动测量双侧黑质致密带、黑质网状带、红核、苍白球、壳核、尾状核头、丘脑和额叶白质区的T2*值,并将所获得数据进行统计分析。结果:①PD组症状同侧与正常对照组同侧在黑质致密部的T2*值差异有统计学意义(P<0.05),在黑质网状部、苍白球、壳核、尾状核头、丘脑和额叶白质区的T2*值差异无统计学意义(P>0.05)。②PD组症状同侧与正常对照组对侧在黑质致密部的T2*值差异有显著统计学意义(P<0.01),在黑质网状部的T2*值差异有统计学意义(P<0.05),在苍白球、壳核、尾状核头、丘脑和额叶白质区的T2*值差异无统计学意义(P>0.05)。③PD组症状对侧与正常对照组对侧在黑质致密部、红核的T2*值差异有统计学意义(P<0.05),而在苍白球、壳核、尾状核头、丘脑和额叶白质区的差异无统计学意义(P>0.05)。④PD组症状对侧与正常对照组同侧各兴趣区的T2*值均无统计学意义(P>0.05)。结论:①在原发性单侧症状PD的亚临床期就有铁的异常沉积;②PD铁异常沉积的部位包括黑质致密部、黑质网状部、红核,与苍白球、壳核、丘脑和尾状核无关。Objective： To compare the difference of T2＊ value in several cerebral regions between idiopathic Parkinson＇s disease（PD） patients and control subjects and to quantitatively analyze the variations of brain iron. Methods： Twenty-four patients with idiopathic PD and 24 healthy controls, ranging in same ages and gender, had routine sequences and SWI sequences by 3.0T MR. T2＊ value was measured in both sides of substantia nigra pars compacta （SNc）, substantia nigra pars reticulata（SNr）, red nueleus（RN）, globus pallidus（GP）, putamen（PUT）, head of caudate nucleus（CN）, thalamus（THA） and frontal white matter（FWM）, and statistically analyzed. Results： ①The T2＊ values was reduced in homolateral side SNc of symptoms of subjects with idiopathic PD compared with the contralateral side （P〈0.05）. There were no differences in other regions （P〉0.05）. ②The T2＊ values was reduced in contralateral side SNc and SNr of symptomatic subjects with idiopathic PD compared with the homolateral side（P〈0.05）. There were no significant difference in other regions（P〉0.05）. ③There was a significant reduction in the T2＊ values in eontralateral side SNc and RN of symptomatic subjects with idiopathic PD compared with the contralateral side（P〈0.05）. There were no differences in other regions（P〉0.05）. ④No significant difference was demonstrated in T2＊ values in all regions in homolateral side of symptomatic subjects with idiopathic PD compared with the contralateral side （P〉0.05）. There was no significant difference in the T2＊ values between the two sides in the idiopathic PD group, the two sides in the subjects group （P〉0.05）. Conclusion： There exists abnormal brain iron deposition before subclinical period in PD. The sites of pathologic iron deposition include SNc, SNr and RN, but not include GP, PUT, CN, THA and FWM.

关 键 词：帕金森病 磁共振成像 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]