MR定量磁敏感图在帕金森病患者黑质和红核铁含量的应用研究  

A Preliminary Study on QSM Imaging at 3.0 T of the Substantia Nigra and Red Nucleus in Parkinson Disease

作　　者：周涛[1] 徐志锋[1] 潘爱珍[1] 雍昉[1] 陈颖瑜[1] 马锦成 ZHOU Tao;XU Zhifeng;PAN Aizhen(Department of Radiology ,the First People＇s Hospital of Foshan, Guagndong 528000 ,P. R. Chin)

机构地区：[1]广东省佛山市第一人民医院影像科

出　　处：《临床放射学杂志》2018年第5期743-746,共4页Journal of Clinical Radiology

基　　金：佛山市科技计划项目(编号:2016AB002451);佛山市科技创新平台项目(编号:2015AG10004);广东省重点专科培育项目(编号:Fspy3-2015013)

摘　　要：目的探讨MR定量磁敏感图（QSM）成像技术测量帕金森病（PD）患者黑质和红核铁含量改变的可行性。方法选择21例经临床确诊的PD患者（PD组）并根据Hoehn-Yahr分期分为早期PD组（9例）和进展期PD组（12例）;同期选择25名年龄及性别相匹配的健康志愿者作为对照组。PD组及对照组均进行脑QSM成像,测量双侧黑质和红核磁敏感值,并取平均值。采用独立样本t检验比较PD组和对照组间红核和黑质的磁敏感值差异;采用单因素方差分析比较正常对照组、早期和进展期PD患者间红核和黑质磁敏感值的差异;采用Sperman相关分析临床Hoehn-Yahr分期与黑质及红核磁敏感值的相关性。结果 PD组黑质和红核的磁敏感值均高于对照组,具有显著统计学意义（P〈0.01）。对照组、早期PD组和进展期PD组患者黑质及红核磁敏感值呈增加趋势,红核的磁敏感值在3组间均具有统计学意义（P〈0.01）,而黑质磁敏感值在对照组及早期PD组间无统计学差异（P〉0.05）。PD组患者Hoehn-Yahr分期与黑质及红核的磁敏感值呈明显正相关（r=0.921,0.775,P〈0.01）。结论QSM技术可以准确测量PD患者黑质和红核铁含量的变化,能为PD临床诊断和病情监测提供根据。Objective To explore the feasibility of MR quantitative susceptibility mapping（QSM） imaging to detect the variations of brain iron of the substantia nigra（SN） and red nucleus（RN） in patients with Parkinson disease（PD）.Methods 21 patients with PD were enrolled and were divided into two subgroups：early-stage（n = 9） and advanced-stage（n = 12） according to Hoehn-Yahr stages.In addition,25 age and sex-matched healthy control subjects were recruited in this study.All the PD patients and healthy controls underwent brain QSM imaging.The susceptibility of bilateral SN and RN were measured on QSM images and the average was calculated.The susceptibility of SN and RN between PD patients and control subjects were compared with independent-samples t test.The difference of susceptibility among normal controls,early-stage PD,and advanced-stage PD patients was assessed with one-way analysis of variance.Spearman analysis was used to analyzed the correlation among the susceptibility of the Hoehn-Yahr stages,early-stage PD and advanced-stage PD patients.Results Compared to normal controls,the susceptibility of SN significantly increased in PD patients（P〈0.01）.The susceptibility of SN and RN in normal controls,early-stage PD and advanced-stage PD displayed increased trend.Significant differences in susceptibility of RN were observed among the three groups（P〈0.01）,and no significant differences in susceptibility of SN were observed between normal controls and early-stage PD patients（P〉0.05）.The Hoehn-Yahr stages had a significant positive correlation with SN and RN（r = 0.921,0.775,P〈0.01）.Conclusion MRQSM can detect accurately the the variations of brain iron of the SN and RN in PD patients,thus,it is a useful tool to diagnose PD and monitor the disease progression.

关 键 词：帕金森病 定量磁敏感图 黑质 红核 脑铁 

分 类 号：R445.2[医药卫生—影像医学与核医学]