帕金森病患者脑部氢质子MR波谱研究  

Metabolic assessment of Parkinson disease by magnetic resonance spectroscopy

作　　者：张尤桥[1] 吴焕泽 关计添[2] 杨杰华[1] 张钦城 陈薇[1] 

机构地区：[1]汕头大学医学院第二附属医院神经内科,汕头515041 [2]汕头大学医学院第二附属医院影像科,汕头515041

出　　处：《磁共振成像》2016年第5期353-358,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：汕头大学医学院临床提升计划科研基金项目(编号:201409)~~

摘　　要：目的应用氢质子磁共振波谱技术(1HMRS)检测帕金森病(PD)患者脑部代谢物变化。材料与方法搜集PD患者42例、健康体检者20例临床资料,进行头颅磁共振(MRI)和磁共振波谱(MRS)检查,测定中脑黑质、大脑苍白球、前额叶、海马区、楔回、背侧丘脑的脑代谢物N-乙酰天冬氨酸/肌酸(NAA/Cr)、N-乙酰天冬氨酸/胆碱化合物(NAA/Cho)、胆碱化合物/肌酸(Cho/Cr)比值;比较两组代谢物的差异性以及代谢物变化与UPDRS评分、病程的相关性。结果 (1)PD组NAA/Cr、NAA/Cho在双侧中脑黑质、苍白球、前额叶、海马区、楔回、背侧丘脑均显著低于对照组(P<0.01);Cho/Cr在右侧海马区、右侧楔回、右背侧丘脑均高于对照组(P<0.05)。(2)PD组双侧黑质(左r=–0.324,P=0.036,右r=–0.399,P=0.009)、右侧苍白球(r=–0.353,P=0.022)、左海马区(r=–0.388,P=0.011)、左楔回(r=–0.325,P=0.036)NAA/Cho与UPDRS呈负相关(均P<0.05);(3)左侧苍白球Cho/Cr比值与病程呈正相关(r=0.327,P=0.034)。结论 PD患者脑部存在广泛神经元损害伴有部分胶质增生,脑代谢异常与临床病情严重程度正相关,并随病程的延长而逐渐加重。Objective： To evaluate the brain metabolite with Parkinson＇s disease（PD）by proton magnetic resonance spectroscopy（1HMRS）. Materials and Methods：Forty-two PD individuals and twenty healthy controls were enrolled in this study. All the subjects were tested with unified Parkinson disease rating scale（UPDRS） scale.Subsequently, individuals underwent MRI and 1HMRS using a GE signa 1.5 T MR,and the ratios of metabolites in the substantia nigra, globus pallidus, prefrontal lobe,hippocampus, cuneus gyrus and dorsal thalamus were compared. Correlations,between brain metabolism with UPDRS the duration, in PD, were analyzed. Results：Significant remarkable declines in the NAA/Cr and NAA/Cho ratios in the bilateral substantia nigra, bilateral globus pallidus, bilateral prefrontal lobe, bilateral hippocampus, bilateral cuneus gyrus, and bilateral dorsal thalamus were found in the PD group（P〈0.01）. A significant increase of the Cho/Cr ratio in the right hippocampus, right cuneus gyrus, and right dorsal thalamus was also found（P〈0.05）.The NAA/Cho ratio in the bilateral substantia nigra（left r=–0.324, P=0.036, right r=–0.399, P=0.009）, right globus pallidus（r=–0.353, P=0.022）, left hippocampus（r=–0.388, P=0.011） and left cuneus gyrus（r=–0.325, P=0.036） were negatively associated with UPDRS scores（P〈0.05）. The NAA/Cr ratio in the left globus pallidus was positively associated with the duration（r=0.327, P=0.034）. Conclusions： PD patients with extensive neuronal damage in the brain and some glial proliferation, thedegree of damage is positively correlated with the clinical severity of the disease and gradually increased with the extension of the course of the disease.

关 键 词：帕金森病 质子磁共振波谱 代谢产物学 脑 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742[医药卫生—诊断学]