早期和晚期帕金森病患者脑铁含量的QSM评价  

Evaluation of Brain Iron Deposition in Early and Advanced Patients with Parkinson’s Disease Using Quantitative Susceptibility Mapping

作　　者：蒋爽 邵华 阿卜杜热合曼·阿卜力米提 王云玲 丁爽 JIANG Shuang;SHAO Hua;Abudureheman-Abulimiti;WANG Yunling;DING Shuang(Department of Radiology,The First Affliated Hospital,Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院影像中心,乌鲁木齐830054

出　　处：《中国医学计算机成像杂志》2022年第4期337-341,共5页Chinese Computed Medical Imaging

基　　金：新疆维吾尔自治区自然科学基金(2020D01C230)。

摘　　要：目的:通过定量磁化率成像(QSM)获得早、晚期帕金森病(PD)患者脑深部核团及丘脑区的定量磁敏感值是否能为临床分级及诊断提供客观的影像学定量指标。方法:研究对象为29例PD患者(PD组)及15名健康对照(HC组),PD组根据Hoehn-Yahr分级又分为早期PD组和晚期PD组。所有受试者进行QSM扫描获得基底节水平及中脑水平灰质核团及丘脑区的定量磁敏感值,采用单因素方差分析及Spearman相关系数分析组间差异及与临床相关性。结果:晚期PD组患者黑质、红核及苍白球的定量磁敏感值均显著高于早期组及对照组(P<0.05),且与临床PD严重程度显著相关(r=0.586,0.497,0.497;P<0.05),早期PD组患者壳核的定量磁敏感值与晚期组及对照组有统计学差异(P<0.05),且与临床分级存在相关性(r=0.419,P<0.05),而丘脑及尾状核各组间比较均无统计学差异(P>0.05)。结论:QSM可以定量评价早、晚期PD局部脑组织铁代谢变化环境,为PD的诊断、监测及延缓病程提供可能。Purpose:To study whether the quantitative susceptibility mapping(QSM)values of deep brain nuclei and thalamic area obtained by quantitative susceptibility weighted imaging can provide objective quantitative imaging indicators for clinical classification and diagnosis of Parkinson’s disease(PD)patients with different degrees.Methods:The subjects were 29 clinically diagnosed PD patients,and were divided into early PD(PD-1)group and advanced PD(PD-2)group based on subject’s Hoehn-Yahr stage.In addition,15 healthy volunteers were recruited as a control group(HC group)in this study.All subjects were scanned with QSM to obtain the QSM values in gray matter nuclei and thalamic areas of the basal ganglia level and midbrain level.One-way ANOVA and Spearman correlation coefficient were used to analyze the differences between groups and their clinical relevance.Results:The QSM values of PD-2 group in substantia nigra,red nucleus,and globus pallidus were significantly higher than those in PD-1 group and HC group,and they were significantly correlated with the clinical severity of PD(r=0.586,0.497,0.497;P<0.05).The QSM values of putamen in PD-1 group were statistically different from that in PD-2 group and HC group,and were correlated with clinical classification of PD(r=0.419,P<0.05).There were no statistical differences among the groups with respect to QSM values in thalamus and the head of caudate nucleus.Conclusion:QSM can be used to quantitatively evaluate the changing environment of local brain region iron metabolism in early and advanced stage PD patients.Furthermore,it can provide the possibility of the diagnosis,monitoring,and delay the course of PD.

关 键 词：帕金森病 定量磁化率成像 铁沉积 

分 类 号：R445.2[医药卫生—影像医学与核医学]