扩散张量成像评估帕金森患者早期病理改变的研究  

A study on the assessment of diffusion tensor imaging for the pathologic change of patients with parkinson disease at early stage

作　　者：方黎 江选东 李中秋[2] 李平[1] 

机构地区：[1]解放军第169医院暨湖南师范大学附属湘南医院医学工程科,湖南衡阳421002 [2]解放军第169医院暨湖南师范大学附属湘南医院神经内科,湖南衡阳421002

出　　处：《中国医学装备》2018年第1期66-69,共4页China Medical Equipment

基　　金：全军医学科学技术研究"十二五"面上课题(CWJ11J276)"湿热环境下颅脑火气伤血脑屏障变化的研究";湖南省卫计委课题(C2017022)"早期预警评分对脑卒中相关性肺炎的预测价值及抗生素管理"

摘　　要：目的:研究扩散张量成像(DTI)对早期帕金森病(PD)患者脑白质改变的诊断价值,对PD临床诊断及其疾病进程分析提供帮助。方法:选取36例早期单侧症状PD患者纳入观察组,另选36名年龄及性别等与观察组相匹配的健康者纳入健康对照组,对两组受检者进行常规MRI头部扫描和DTI检查,计算出全脑的部分各项异性及平均弥散率差异,并形成图像,采用基于体素的分析(VBA)方法,分析对比两组病理生理变化。结果:观察组与健康对照组相比,其PD患者小脑后叶、旁中央小叶以及颞叶部位的各向异性分数(FA)值降低,平均弥散率(MD)值增高,辅助运动区(SMA)FA值和MD值均降低,两组比较差异有统计学意义(t=5.3425,t=2.9568,t=2.7864,t=3.1765,t=2.8654,t=3.9868;P<0.05)和(t=3.7647,t=5.1321,t=4.3452,t=2.8974,t=7.6746,t=3.3342;P<0.05)。结论:DTI通过定量检测PD病变区域的FA值与MD值,有利于PD的早期诊断;DTI在PD的在体研究中效果显著,能发现更多与病理机制及临床症状相关的信息。Objective To investigate the diagnostic value of diffusion tensor imaging （DTI） on the change of alba of patients with Parkinson disease （PD） at early stage, the clinical diagnosis of PD and the analysis of their disease progress. Methods： 36 patients with early unilateral symptom of PD were divided into observation group, and 36 healthy subjects who were matched with patients of observation group at age, gender and other factors were divided into control group. All of them underwent the head scan of routine MR and detection of DTI, respectively, and the part of anisotropic difference of whole brain and the difference of mean diffusivity （MD） were calculated, respectively, and then the relevant image were formed based on above data. Besides, the voxel-based analysis （VBA） was adopted to analyze and compare the pathological and physiological change of the two groups. Results： Compared with the healthy control group, the anisotropy fraction （FA） value of the posterior lobe of cerebellum, paracentral lobule and temporal lobe of patients with PD in observation group were lower, and the MD values of them were higher. For six regions, included of posterior lobe of right epencephalon, posterior lobe of left epencephalon, temporal lobe of right side, middle occipital gyrus of right side, paracentral lobule of right side and supplementary motor area （SMA） of right side, the differences of FA between the two groups were significant, （t=5.3425, t=2.9568, t=2.7864, t=3.1765, t=2.8654, t=3.9868, P〈0.05）, respectively. Besides, the MD value of six regions, included of paracentral lobule, tonsil of cerebellum of right side, cingulate gyrus of left side, posterior lobe of right epencephalon and temporal lobe of right side, of observation group were significantly higher than that of control group （t=3.7647, t=5.1321, t=4.3452, t=2.8974, t=7.6746, t=3.3342, P〈0.05）. Conclusion： Through quantitatively detects FA and MD values for lesion area of patients with PD by using DTI, it is bene

关 键 词：帕金森病 扩散张量成像 脑白质 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]