帕金森病治疗前后QSM及DKI改变  

Evaluation of the efficacy of QSM combined with DKI in the treatment of Parkinson’s disease with dopamine receptor agonist

作　　者：程艳华 常莹 雷杰 周宏伟[2] 孟姮[3] CHENG Yanhua;CHANG Ying;LEI Jie(Department of MR of JiLin Province FAW General Hospital,ChangChun 130000,China)

机构地区：[1]吉林省一汽总医院核磁科,吉林长春130000 [2]吉林大学白求恩第一医院放射科,吉林长春130021 [3]北华大学附属医院医学影像中心,吉林吉林132011

出　　处：《中风与神经疾病杂志》2020年第11期994-998,共5页Journal of Apoplexy and Nervous Diseases

基　　金：吉林省教育厅项目(No.JJKH20180368KJ);国家自然科学基金(No.81771803)。

摘　　要：目的探讨QSM联合DKI对多巴胺受体激动剂治疗帕金森病疗效的评估价值。方法选取在2016年6月至2018年12月间就诊于北华大学神经内科的确诊为帕金森病的患者60例,健康志愿者20例作为对照组,所有PD患者服用美多芭,于服药前与服药半年后分别行进行帕金森综合评分量表(UPDRS)评分、磁敏感定量成像(QSM)与弥散峰度成像(DKI)检查,评估治疗前后患者的病情变化;志愿者行磁敏感定量成像(QSM)与弥散峰度成像(DKI)检查。由两名医生人工绘制双侧大脑半球深部核团:黑质、红核、壳核、尾状核、丘脑、苍白球的感兴趣区(ROI)范围,并测得DKI参数平均弥散峰度(mean kurtosis,MK)值及磁化率值。对相关数据进行统计学分析。结果治疗前后组各组内各核团磁化率值、MK值均无侧别差异(P>0.05),患者经美多芭治疗后半年,UPDRS评分值为(17.0±0.87),显著低于治疗前(19.0±0.68),差异有统计学意义(P<0.05);患者治疗前双侧黑质、红核、壳核、尾状核、苍白球磁化率值明显高于对照组,差异有统计学意义(P<0.05),双侧黑质和壳核的磁化率值较治疗前有所下降,差异有统计学意义(P<0.05);患者治疗前双侧黑质、左侧红核、左侧尾状核、双侧丘脑MK值与正常组比较,明显升高,差值有统计学意义(P<0.05),治疗后左侧黑质、红核、右侧黑质的MK值分别为(0.936±0.430、0.883±0.377、1.017±0.474),相比于治疗前(0.588±0.216、0.581±0.235、0.603±0.210)明显升高,差异有统计学意义(P<0.05);最后,在对比UPDRS评分和MK值及磁化率值的相关性时,患者左侧壳核的磁化率值与患者UPDRS的评分有明显的相关性(P<0.05)。结论美多芭对帕金森病的治疗有较好的效果,QSM联合DKI为美多芭疗效评估提供客观依据,其中左侧壳核的磁化率值与UPDRS评分具有明显的相关性。Objective To evaluate the efficacy of QSM combined with DKI in the treatment of Parkinson’s disease.Methods In June 2016 to December 2018 in the Beihua University neurology patients diagnosed with Parkinson’s disease of 60 cases and 20 healthy volunteers as control group.All patients taking Madopar,UPDRS score,magnetic sensitive quantitative imaging(QSM),and diffusion kurtosis imaging(DKI)were performed before and six months after treatment to evaluate the changes of patients’condition.All volunteers underwent magnetic sensitivity quantitative imaging(QSM)and diffusion kurtosis imaging(DKI)examination.Two doctors manually drew the range of ROI for the deep nuclear masses of both cerebral hemispheres:substantia nigra,red nucleus,putamen,caudate nucleus,thalamus and globule,and measured the mean kurtosis(MK)value of DKI parameters and the value of magnetic susceptibility.Statistical analysis was performed on the relevant data.Results There were no lateral differences in the magnetic susceptibility and MK values of each nuclear group before and after treatment(P>0.05),The patient was treated with madopar for six months,the UPDRS score of the patients was(17.0±0.87),significantly lower than that of(19.0±0.68)before treatment,and the difference was statistically significant(P<0.05),Before treatment,the magnetic susceptibility of bilateral substantia nigra,red nucleus,shell nucleus,caudate nucleus and globus pallidus was significantly higher than that of normal control group(P<0.05),the magnetic susceptibility values of bilateral substantia nigra and putamen decreased compared with that before treatment,and the difference was statistically significant(P<0.05),the MK values of bilateral substantia nigra,left red nucleus,left caudate nucleus and bilateral colliculus before treatment were significantly higher than those of normal group(P<0.05),after treatment,the MK values of the left melanocytes,red nuclei and right melanocytes were 0.936±0.430,0.883±0.377 and 1.017±0.474,respectively,which were significantly

关 键 词：定量磁敏感成像 弥散峰度成像 美多芭 帕金森病 

分 类 号：R742.5[医药卫生—神经病学与精神病学]