帕金森轻度认知障碍患者脑深部核团及白质扩散峰度成像的特点  

Diffusion kurtosis imaging characteristics of deep brain nuclei and white matter in Parkinson's disease with mild cognitive impairment

作　　者：许晓辉 蔡卫卫 张莉 段智慧 XU Xiaohui;CAI Weiwei;ZHANG Li;DUAN Zhihui(Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471000,China)

机构地区：[1]郑州大学附属洛阳中心医院,河南洛阳471000

出　　处：《中国实用神经疾病杂志》2021年第16期1390-1398,共9页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20191204,LHGJ20191202)。

摘　　要：目的探讨帕金森病轻度认知功能障碍(PD-MCI)患者脑深部核团及白质微观结构改变的特点以及MRI扩散峰度成像(DKI)在PD-MCI诊断中的价值。方法纳入患者根据有无轻度认知障碍分为PD-MCI组(21例)和PD-nMCI组(23例),选取同期健康体检者为对照组(20例)。所有受试者行常规MRI、SWI、DWI、FLAIR及扩散峰度成像(DKI)检查,获得平均扩散峰度(MK)、各向异性分数(FA)参数,比较各组FA值及MK值,并分析PD-MCI组DKI各参数值与MMSE、MoCA评分的相关性。结果PD-MCI组与PD-nMCI组双侧海马、丘脑、额叶FA值均明显低于对照组,差异有统计学意义(P<0.05)。3组黑质、左侧海马、丘脑、胼胝体压部、额叶的MK值比较差异有统计学意义(P<0.05)。对差异有统计学意义的感兴趣区数据进行2组间比较,PD-MCI组双侧海马、丘脑、额叶FA值明显低于对照组(P<0.05),PD-MCI组额叶FA值低于PD-nMCI组(P<0.05)。PD-MCI组黑质、丘脑MK值高于对照组(P<0.05),胼胝体压部、左侧海马、额叶MK值小于对照组(P<0.05)。PD-MCI组额叶、胼胝体压部MK值低于PD-nMCI组(P<0.05)。左侧海马、额叶FA值与MMSE评分、MoCA评分呈正相关(P<0.05),左侧海马、丘脑、胼胝体压部、额叶MK值与MoCA评分呈正相关(P<0.05)。结论PD-MCI患者脑深部核团、白质结构存在微结构异常,以黑质、海马、胼胝体压部、丘脑、额叶更加明显。DKI作为一种无创技术可以探测到帕金森病认知障碍患者脑结构的细微改变,MK值作为神经影像标志物,可能为PD-MCI的诊断提供客观影像依据。Objective To investigate the characteristics between the microstructural changes of deep brain nuclei and white matter in patients with mild cognitive impairment of Parkinson’s disease(PD-MCI)and the val⁃ue of MRI diffusion kurtosis imaging(DKI).Methods Patients were divided into PD-MCI group(21 cases)and PD-nMCI group(23 cases)according to whether they had mild cognitive impairment.The healthy people in the same period were selected as the control group(20 cases).All subjects underwent routine MRI,SWI,DWI,FLAIR and DKI,and obtained mean kurtosis(MK)and fraction anisotropy(FA)parameters.The differences of FA and MK values in each group were compared,and the correlation between DKI parameters and MMSE and MoCA scores in PD-MCI group was analyzed.Results The FA values of bilateral hippocampus,thalamus and frontal lobe in the three groups were significantly lower than those in the healthy control group,and the difference was sta⁃tistically significant(P<0.05).Comparing the three groups,it was found that the MK values of substantia nigra,left hippocampus,thalamus,corpus callosum pressure,and frontal lobe were statistically significant(P<0.05).Compared with the healthy control group,the FA values of bilateral hippocampus,thalamus and frontal lobe in PD-MCI group were significantly lower than those in healthy control group(P<0.05),and the FA values of fron⁃tal lobe in PD-MCI group were lower than those in PD-nMCI group(P<0.05).The MK values of substantia nig⁃ra and thalamus in PD-MCI group were higher than those in healthy control group(P<0.05),while the MK val⁃ues of corpus callosum,left hippocampus and frontal lobe were lower than those in healthy control group(P<0.05).The MK values of frontal lobe and corpus callosum in PD-MCI group were lower than those in PD-nMCI group(P<0.05).The FA value of left hippocampus and frontal lobe was positively correlated with MMSE score and MoCA score(P<0.05),and the MK value of left hippocampus,thalamus,corpus callosum pressure and fron⁃tal lobe was positively correlat

关 键 词：帕金森病 认知障碍 扩散峰度成像 平均扩散峰度 各向异性分数 

分 类 号：R742.5[医药卫生—神经病学与精神病学]