神经突方向离散度与密度成像对帕金森病脑深部核团的临床研究  

Clinical research of NODDI technology in deep brain nucleus of Parkinson’s disease

作　　者：黄小盼 韩鸿宇 王敏[1] 马东辉 李沛珊 王红[1] HUANG Xiaopan;HAN Hongyu;WANG Min;MA Donghui;LI Peishan;WANG Hong(Department of Radiology,Second Affiliated Hospital of Xinjiang Medical Univer sity,Urumqi 830063,China)

机构地区：[1]新疆医科大学第二附属医院影像科,乌鲁木齐830063

出　　处：《磁共振成像》2021年第3期6-9,19,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：新疆维吾尔自治区自然科学基金(编号:2019D01C227)。

摘　　要：目的利用神经突方向离散度与密度成像(neurite orientation dispersion and density imaging,NODDI)探索帕金森病患者(Parkinson’s disease,PD)灰质核团微结构变化。材料与方法对36例PD患者和26例健康者进行MRI扫描和NODDI图像后处理,比较两组神经突体积分数(intracellular volume fraction,Vic)、神经突方向分散度(orientation dispersion index,ODI),通过受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)评估不同核团Vic值诊断效能。结果与对照组相比,PD患者左侧黑质(P<0.001)、丘脑(P=0.003)及右侧尾状核头(P=0.002)、壳核(P<0.001)、苍白球(P<0.001)、黑质(P<0.001)、红核(P<0.001)、丘脑(P=0.006)Vic值差异有统计学意义,且左侧黑质(P<0.001)及右侧尾状核头(P=0.038)、壳核(P=0.001)、苍白球(P=0.023)、黑质(P<0.001)、红核(P=0.023)ODI值差异有统计学意义。ROC曲线显示,右侧黑质、红核、苍白球、壳核Vic指标诊断PD的曲线下面积(area under curve,AUC)分别为0.861、0.788、0.852、0.843。此外,右侧黑质苍白球及黑质壳核Vic值联合诊断PD的AUC分别为0.925、0.921。结论NODDI技术可以定性区分PD患者和健康人群,量化分析PD脑深部灰质核团微结构改变情况。Vic指标在黑质部位显示出最佳诊断效能,且黑质苍白球及黑质壳核的联合诊断的诊断效能均优于单一核团,这一发现为PD诊断提供新的神经影像学支持。Objective:To investigate microstructural changes of gray matter nucleus in people with Parkinson’s Disease(PD)by neurite orientation dispersion and density imaging(NODDI).Materials and Methods:Thirty-six PD patients and 26 healty volunteers underwent MRI and were divided into the case group and the control group,NODDI images were analyzed and processed.Intracellular volume fraction(Vic)and orientation dispersion index(ODI)from the case group were separately compared with those from the control group,and receiver operating characteristic curve(ROC)evaluated the diagnostic efficiency of different nucleus.Results:The Vic values of left substantia nigra(P<0.001),thalamus(P=0.003),right caudate nucleus head(P=0.002),putamen(P<0.001),globus pallidus(P<0.001),substantia nigra(P<0.001),red nucleus(P<0.001)and thalamus(P=0.006)in PD patients were significantly different from those in the control group.Compared with the control group,the ODI values of left substantia nigra(P<0.001),right caudate nucleus head(P=0.038),putamen(P=0.001),globus pallidus(P=0.023)substantia nigra(P<0.001)and red nucleus(P=0.023)in PD patients showed significantly difference.Meanwhile,the ROC curve showed that area under curve(AUC)of the Vic values for PD’s diagnosis were respectively 0.861,0.788,0.852,0.843 in right substantia nigra,red nucleus,globus pallidus and putamen.In addition,the AUC of the combined diagnosis of substantia nigra and globus pallidus,substantia nigra and putamen were separately 0.925,0.921.Conclusion:NODDI can qualitatively distinguish between PD patients and healthy volunteers,and quantitatively analyze microstructural changes of deep brain nucleus.And the joint diagnosis of nucleus can obtain higher value,which is helpful for PD’s clinical diagnosis.

关 键 词：神经突方向离散度与密度成像 核团 帕金森病 磁共振成像 黑质纹状体 

分 类 号：R445.2[医药卫生—影像医学与核医学] R657.51[医药卫生—诊断学]