磁共振扩散张量成像在帕金森病诊断中的应用研究  

Application of diffusion tensor imaging in early diagnosis of Parkinson＇s disease

作　　者：江名芳[1] 牛广明[2] 云强 高阳[2] 石峰[2] 

机构地区：[1]内蒙古医科大学附属医院神经内科,内蒙古呼和浩特010059 [2]内蒙古医科大学附属医院影像科,内蒙古呼和浩特010059 [3]内蒙古自治区人民医院神经外科

出　　处：《实用放射学杂志》2015年第12期1937-1941,共5页Journal of Practical Radiology

基　　金：内蒙古医科大学科技百万项目（YKD2013KJBW016）内蒙古自治区自然科学基金（2014MS0874）.

摘　　要：目的 研究磁共振扩散张量成像（DTI）在帕金森病（PD）诊断中的作用和应用价值。方法 PD患者31例和健康对照组34例行常规磁共振平扫和磁共振DTI检查，测量双侧黑质、红核、基底核及额叶白质的FA值和ADC值并计算双侧的平均值，病例组进行UPDRS、MoCA和HAMD抑郁评分，将各项得分与部分各向异性指数（FA）值和表观扩散系数（ADC）值进行相关性分析。结果 PD组黑质、壳核和额叶白质的FA值均低于对照组,PD组额叶白质的ADC值高于对照组,且2组之间的差异有统计学意义（P＜0.05）；PD组依照H-Y分级分组，黑质FA值和丘脑ADC值在各组间有统计学差异（P＜0.05）,随着疾病进展,黑质FA值逐渐降低,丘脑ADC值逐渐升高；PD组根据ADL评分分组，苍白球的ADC值在各组之间有统计学差异（P＜0.05）,ADL评分越高ADC值越高；PD组根据HAMD抑郁量表分组，壳核、尾状核及额叶白质ADC值在不同组别之间有统计学差异（P＜0.05）,HAMD得分越高ADC值也越高。PD组额叶白质FA值与ADL评分呈负相关（r=-0.498,P＜0.05）。结论 磁共振DTI在PD诊断和发生机制研究中可以发挥积极的作用。Objective To evaluate the diagnostic value of DTI in Parkinson＇s disease. Methods Both 31 patients with Parkinson＇s disease and 34 healthy subjects were scanned with conventional MRI and DTI. On DTI,bilateral average FA and ADC values in the nigra, red nucleus, basal ganglia,frontal white matter were measured and calculated, and the correlation of FA and ADC values with MoCA, H AMD,ADL and UPDRSⅢ scores in 31 cases of Parkinson＇s disease was analyzed. Results FA values in the nigra, putamen, and frontal white matter on PD group was lower than that on control group, the frontal white matter＇s ADC values on PD group was higher than that on control group,and the difference was statistically significant（ P〈0.05 ）. The case group was divide into the early group,mid and late group in accordance with H-Y graded,FA values in the substantia nigra and ADC values in the thalamus were significantly different （P〈0.05） in three groups, and FA values in the substantia nigra decreased and ADC values in the thalamus increased along with disease progression. The patients were divided some groups according to ADL, ADC value of the globus pallidus were significantly different among these groups （P〈0. 05）, the ADC value increased along with the ADL score. According to HAMD depression scale,the cases were divided into four groups,ADC values in the putamen,caudate nucleus and frontal white matter were significantly different in the different groups （P〈0.05）, the higher ADC value was, the higher HAMD score was along with. There was negative correlation between the FA values in the frontal white matter and the ADL scores in PD patients （r=-0. 498 ,P〈 0.05）. Conclusion DTI can be used to study the metabolism in patients with PD,which might be helpful to diagnosis of PD.

关 键 词：帕金森病 磁共振成像 扩散张量成像 

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