多回波采集T2＊WI三维梯度回波序列测量黑质小体形态特征及与帕金森病的关系探讨  

Detail of the appearance of nigrosome-1 and its application in the diagnosis of Parkinson disease at 3 T enhanced gradient echo T2 star weighted angiography

作　　者：高平[1] 周佩洋[2] 李光[1] 王普清[2] 刘焦枝[1] 徐峰[1] 武夏夏[1] 

机构地区：[1]湖北医药学院附属襄阳医院影像科,441000 [2]湖北医药学院附属襄阳医院神经内科,441000

出　　处：《中华放射学杂志》2016年第1期3-7,共5页Chinese Journal of Radiology

摘　　要：目的采用3．0T多回波采集T2＊WI三维梯度回波序列（ESWAN）分析黑质小体．1区的具体影像特征，探讨其在帕金森病（PD）诊断中的应用价值。方法连续选取2012年6月至2014年5月54例确诊PD患者（PD组）及51名非PD病志愿者（对照组）行3．0TESWAN序列扫描，在幅度图上对黑质内黑质小体．1区特征高信号最宽处（a）、同层黑质与楔形高信号长轴垂直的中段宽度（b）、椭圆形部分消失后残余带状高信号最宽处（c）进行测量、数据采集，由2名医师按征象的“有”、“无”重新分类的结果与临床金标准对照，并计算判断PD的敏感度及特异度。连续选取新收入的11例临床疑似PD患者（UD组）做同样检查，按前述研究所得结论对其行影像诊断，将做出的诊断与之后的临床最终诊断行对照研究。结果对照组51名中49名（96．08％）均在双侧或单侧黑质致密部后外侧见黑质小体-1区特异性高信号，该高信号可呈“水滴”状、楔形及椭圆形外观，其大小（a／b）平均为（0．31±0．07）mm。PD组中所有患者（100％）“水滴”后方椭圆形高信号均表现缺失，黑质小体-1高信号的缺失用于判定PD的敏感度达100．0％（54／54）、特异度约96．1％（49／51）。UD组11例中7例“水滴”状高信号完全缺失者及1例双侧“c”值较小者经临床证实为PD，2例特征高信号存在者及2例C值较大者入院后确诊为帕金森叠加综合征。结论PD患者在3．0TESWAN上黑质小体-1区特征高信号消失，分析该高信号存在与否及其尺寸有可能是诊断PD和鉴别PD与帕金森叠加综合征的有效方法。Objective To investigate the imaging features of the nigrosomes-1 region in the substantia nigra at 3.0 T with enhanced gradient echo T2 star weighted angiography（ESWAN）, and to explore its clinical value in the evaluation of Parkinson disease （PD）. Methods Fifty-four patients diagnosed with PD （PD group）, and 51 non-PD volunteers （N-PD group） were scanned with 3.0 T ESWAN, who had selected randomly. The widths of the typical high signal correspondence with the nigrosomes-1 region （a）, the width at the middle of the substantia nigra （b） and the width of the banded high signal of which the oval structure were not displayed （c） were measured and collected. The resuh of reclassification performed by 2 physicians were compared with clinical gold standard. Specificity and sensitivity were calculated; Eleven outpatients with clinically suspected PD but undiagnosed （UD group） were continusouly selected. They received the same scanning and were performed with imaging diagnosis according to the conclusions of previous studies, then compared the imaging diagnosis with the final clinical diagnosis. Results In non PD group, hyperintensity of nigrosomes-1 were shown in 49 cases （96.1%） in bilateral or unilateral of the SN, the hyperintensity were shaped as ＂drop＂, wedge or oval and the average size （a/b） was （0.31±0.07）mm approximately; PD group, all 54 cases （100.0%） of the oval rear the ＂drop＂ were completely disappeared. The sensitivity of the loss of the hyperintensity of nigrosomes-1 for the diagnosis of PD was about 100.0% （54±54）and the specificity of it was about 96.08%（49/51）. In UD group, 7 cases with the ＂drop＂ completely missed and 1 case with smaller ＂c＂ were chnically proven to PD, 2 cases with the typical hyperintensity and 2 case with larger ＂c＂ were proven to Parkinson plus syndrome. Conclusions The nigrosomes-1 typical hyperintensity in PD patients＇ substantia nigra on the 3.0 T ESWAN are disappeared. There may be an effective me

关 键 词：帕金森病 磁共振成像 黑质 

分 类 号：R445.2[医药卫生—影像医学与核医学]