帕金森病患者基底节区的磁共振氨基质子转移成像研究  

Amide proton transfer MR imaging at 3.0 T of the basal ganglia in Parkinson＇s disease

作　　者：王蕊[1] 李春媚[1] 陈敏[1] 张晨[1] 周进元 苏闻[3] 

机构地区：[1]北京医院放射科,100730 [2]Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA [3]北京医院神经内科,100730

出　　处：《中华神经科杂志》2015年第1期40-43,共4页Chinese Journal of Neurology

基　　金：“十二五”国家科技支撑计划项目（2012BAI10B04,2012BAI10B03）

摘　　要：目的 探讨磁共振氨基质子转移成像（APT）技术对于发现帕金森病患者基底节异常改变的可行性.方法 收集27例帕金森病患者和23名年龄及性别相匹配的健康对照者进行头颅APT成像和常规磁共振检查.测量双侧苍白球、壳核和尾状核的酰胺质子不对称磁化转移率（MTRasym）,分别采用独立样本t检验和配对样本t检验比较帕金森病患者与健康对照者、帕金森病患者起病侧和对侧各脑结构MTRasym （3.5 ppm）的差异.使用单因素方差分析比较健康对照者和不同严重程度帕金森病患者间各脑结构MTRasym（3.5 ppm）的差异.结果 帕金森病患者苍白球、壳核和尾状核的MTRasym （3.5 ppm）均高于健康对照者[分别为（0.89±0.12）％与（0.57 ±0.16）％,（1.05±0.11）％与（0.82±0.15）％,（1.15±0.13）％与（0.78 ± 0.19）％;t=3.311、2.562和3.277,均P＜0.05].健康对照组、轻度和中重度帕金森病组基底节各脑结构MTRasym（3.5 ppm）的差异具有统计学意义,且轻度帕金森病患者苍白球、壳核和尾状核的MTRasym（3.5 ppm）明显高于健康对照者.帕金森病患者基底节各脑结构起病侧的MTRasym（3.5 ppm）虽均略低于对侧,但差异均无统计学意义.结论 APT成像技术可以敏感地显示早期帕金森病患者和健康对照者基底节各脑结构MTRasym（3.5 ppm）的差异,是一种评价帕金森病患者脑代谢异常的有效工具.Objective To explore the feasibility of amide proton transfer （APT） MR imaging for the detection of basal ganglia abnormalities in patients with Parkinson＇ s disease （PD）.Methods Twentyseven patients with PD and twenty-three age-matched normal control subjects underwent cerebral APT and structural MR imaging.The magnetic resonance ratio asymmetry （MTRasym） values at 3.5 ppm of bilateral globus pallidus,putamen and caudate were measured on APT images.MTRasym （3.5 ppm） values of cerebral structures between PD patients and control subjects were compared with independent-samples t test.Paired-samples t test was used to compare the difference of MTRasym （3.5 ppm） between the side of onset and contralateral side in patients with PD.The difference of MTRasym （3.5 ppm） among normal controls,early-stage PD,and advanced-stage PD patients was assessed with one-way analysis of variance.Results Compared to normal controls,MTRasym（3.5 ppm） values of globus pallidus,putamen and caudate were significantly increased in PD patients （（0.89 ±0.12）％ vs （0.57 ±0.16）％,（1.05 ± 0.11）％ vs （0.82 ± 0.15）％,（1.15 ±0.13）％ vs （0.78 ±0.19）％; t =3.311,2.562,3.277 respectively,all P values ＜ 0.05）.Significant differences in MTRasym （3.5 ppm） values of these cerebral structures were observed among normal controls,early-stage PD and advanced-stage PD patients.And MTRasym （3.5 ppm） values in globus pallidus,putamen and caudate were significantly higher in early-stage PD patients than normal controls.In PD patients,even not statistically significant,MTRasym （3.5 ppm）values of sides of onset were slightly lower than contralateral sides.Conclusions APT MR imaging can sensitively identify the difference of MTRasym （3.5 ppm） in the basal ganglia between PD patients and normal controls.APT might be a useful tool to evaluate abnormal metabolite in basal ganglia of PD patients.

关 键 词：帕金森病 基底神经节 磁共振成像 氨基质子转移 

分 类 号：R742.5[医药卫生—神经病学与精神病学]