出 处:《实用放射学杂志》2017年第11期1661-1664,1678,共5页Journal of Practical Radiology
摘 要:目的 探讨MR扩散加权成像(DWI)在多系统萎缩(MSA)、进行性核上性麻痹(PSP)和帕金森病(PD)诊断及其鉴别诊断中的应用价值。方法 选取经临床诊断为MSA的患者24例、PD 35例、PSP 12例和年龄匹配的32例正常人(对照组)行常规MRI和DWI扫描。DWI采用单次激发自旋回波平面回波序列,测量感兴趣区(ROI)为基底节(壳核、苍白球、尾状核)、丘脑、小脑中脚及小脑上脚,运用单因素方差分析对各组表观扩散系数(ADC)值进行统计学分析。结果 PSP组的壳核、苍白球、尾状核及小脑上脚的ADC值最大[(0.75±0.43)×10^-3 mm^2/s、(0.77±0.06)×10^-3 mm^2/s、(0.77±0.44)×10^-3 mm^2/s及(1.11±0.22)×10^-3 mm^2/s],其中苍白球、尾状核的ADC值与MSA组[(0.73±0.04)×10^-3 mm^2/s、(0.73±0.40)×10^-3 mm^2/s]、PD组[(0.67±0.11)×10^-3 mm^2/s、(0.73±0.04)×10^-3 mm^2/s]及对照组[(0.71±0.05)×10^-3 mm^2/s及(0.72±0.04)×10^-3 mm^2/s]比较差异均有统计学意义(P<0.05);MSA组小脑中脚ADC值最大[(0.95±0.16)×10^-3 mm^2/s],与PSP组、PD组及对照组[(0.74±0.49)×10^-3 mm^2/s、(0.69±0.50)×10^-3 mm^2/s、(0.68±0.31)×10^-3 mm^2/s]比较差异均有统计学意义(P<0.01);PD组和对照组的壳核、苍白球、尾状核、丘脑、小脑中脚及小脑上脚比较差异均无统计学意义(P>0.05)。结论 基底节、小脑上脚及小脑中脚ADC值测量对于MSA、PSP及PD的鉴别诊断有重要意义。Objective To explore the diffusion-weighted imaging(DWI) values in diagnosis and differential diagnosis in multiple system atrophy (MSA) , progressive supranuelear pMsy (PSP) and Parkinson's disease (PD). Methods Conventional MRI and DWI were performed in 24 clinically proved MSA patients, 35 PD patients, 12 PSP patients, and 32 age-matched normal controls (the control group}.DWI was performed using a single shot-spin echo-echo planar imaging sequence, and ADC values were measured in the ROIs of different brain regions(including basal ganglia, thalamus,middle cerebellar peduncles and superior cerebellar peduncles). Then one way ANOVA test was used for statistical analysis.Results PSP group had the largest ADC values in putamen,globus pallidus, caudate,and superior cerebellar peduncles[(0.75±0.43)×10^-3 mm^2/s, (0.77±0.06)×10^-3 mm^2/s, (0.77±0.44)×10^-3 mm^2/s and (1.11± 0.22)×10^-3 mm^2/s]. The ADC values of globus pallidus and caudate had statistically difference comparing with MSA [(0.73±0.04) ×10^-3 mm^2/s and (0.73±0.40)×10^-3 mm^2/s], PD[[ 0.67±0.11 ) ×10^-3 mm^2/s and (0.73±0.04}×10^-3 mm^2/s], and control group[(0.71±0.05) ×10^-3 mm^2/s and (0.72±0.04)×10^-3 mm^2/s]. MSA group had the largest ADC values in middle cerebellar peduncles[-(0.95±0.16)×10^-3 mm^2/s], and there was statistically significant difference, comparing with PSP, PD and control groupl-(0.74±0.49)×10^-3 mm^2/s,(0.69±0.50)×10^-3 mm^2/s and (0.68±0.31)×10^-3 mm^2/s]. The ADC values of PD group and control group had no statistically significant difference in putamen, globus pallidus, caudate, thalamus, middle cerebellar peduncles and superior cerebellar peduneles(P〉0.05).Conclusion ADC values in the basal ganglia, the middle cerehellar peduncles and superior eerehellar peduncles have very important significance in differential diagnosis in MSA, PSP and PD.
关 键 词:多系统萎缩 进行性核上性麻痹 帕金森病 磁共振成像
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]
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