磁敏感加权成像对帕金森病脑核团的显示及其铁沉积差异测定  

The visibility of nuclei in patients with parkinson's disease using susceptibility-weighted imaging and the measurement of iron deposition differences in those nuclei

作　　者：王铁铮[1] 林祥涛[1] 赵斌[1] 

机构地区：[1]山东大学医学院山东省医学影像学研究所,山东济南250021

出　　处：《医学影像学杂志》2013年第9期1345-1349,共5页Journal of Medical Imaging

摘　　要：目的评价磁敏感加权成像(SWI)对帕金森病(PD)患者苍白球内侧部、丘脑底核和丘脑腹中间核的显示能力并测定不同核团铁含量差异。方法收集PD患者15名作为研究组,性别和年龄匹配的健康志愿者15名为正常对照组,采用3.0T MR对两组行SWI及常规MR序列成像,根据核团与周围脑组织间的信号对比、边界清晰度、核团信号均匀性等方面,由两名有经验的影像科医师对图像的质量进行评分,共分为1、2、3、4四个等级;比较SWI与常规MR各序列对三个核团的显示能力,并在SWI校正后的相位图上测量研究组与正常对照组间核团之间的相位值,采用独立样本t检验比较分析差异。结果在SWI序列,PD患者各个核团显示清晰;在FSE-T2WI及T2WI-FLAIR像,大多数患者的核团显示欠佳;在T1WI-FLAIR像大多数患者的核团难以分辨;经秩和检验,四组间对诸核团的显示质量存在显著差异。研究组与正常组比较所得相位值差,在苍白球内侧部及丘脑底核有统计学意义(t值分别为11.693,6.958,P<0.05),提示存在铁质沉积改变;在丘脑腹中间核无统计学意义(t=0.755,P>0.05),提示无明显铁质沉积改变。结论磁敏感加权成像较常规MR序列在显示帕金森患者苍白球内侧部、丘脑底核和丘脑腹中间核结构方面更准确,且能够检测不同核团铁沉积量的差异。Objective To evaluate the visibility of the globus pallidus interna （Gpi）, subthalamic nucleus （STN） and ventral intermediate nucleus （Vim） using susceptibility-weighted imaging （SWI） for Parkinson＇s disease （PD）; To meas-ure the differences of iron deposition in those nuclei between the PD group and the control group. Methods 15 PD patients were collected as the PD group and 15 age-and sex-matched volunteers were collected as the control group. All of them had been scanned with SWI sequences and conventional MR sequences by 3.0 T MR. According to the uniformity of the nucle us, signal contrast, and border sharpness between the Gpi, STN, Vim and surrounding structures, the images were clas- sified to four grades （grade 1, 2, 3, 4） by 2 experienced radiologists. The visibility of the three nuclei was evaluated in those sequences. And the phase values of those nuclei were respectively measured on corrected phase images. The inde pendent sample T test was used to compare the phase values. Results In SWI sequences, those nuclei in patients with PD were clearly visualized. In FSE-T2WI and T2 WI -FLAIR sequences, most of those nuclei couldn＇t be identified easily. In TWI-FLAIR sequences, most of those nuclei could hardly be identified. Significant differences were found among those four sequences. And there were statistically significant differences in the average phase values between the PD group and the control group in globus pallidus interna （ t =11. 693, P d0.05） and subthalamic nucleus （ t= 6. 958, P d0.05）, in- dicating the existence of iron deposition. But no significant difference was found in ventral intermediate nucleus （ t= 0. 755, P 〉0.05）, indicating no iron deposition. Conclusion Compared to conventional MR sequences, SWI improves the visibility of the Gpi, STN, Vim. And it can detect the different iron deposition changes in different nuclei.

关 键 词：磁敏感加权成像 帕金森病 苍白球内侧部 丘脑腹中间核 铁沉积 

分 类 号：R742[医药卫生—神经病学与精神病学]