磁共振扩散峰度成像技术在帕金森病早期诊断中的价值  

The value of diffusion kurtosis imaging in the early diagnosis of Parkinson's disease

作　　者：戴凯峰[1] 陈向荣[1] 许淑惠[1] 林钱森 蔡雅丽[1] 陈杰云[1] DAI Kaifeng;CHEN Xiangrong;XU Shuhui;LIN qiansen;CAI Yali;CHEN Jieyun(Department of Imaging,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou 362000,China)

机构地区：[1]福建医科大学附属泉州第一医院影像科,泉州362000

出　　处：《磁共振成像》2022年第9期81-85,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：泉州市科技计划项目(编号:2018N047S)。

摘　　要：目的探讨磁共振扩散峰度成像(diffusion kurtosis imaging,DKI)技术在帕金森病早期诊断中的价值。材料与方法前瞻性随机纳入2018年1月至2021年6月我院帕金森病(Parkinson's disease,PD)专科确诊的PD患者50例作为PD组,同时纳入来我院进行健康体检的健康志愿者50例作为健康对照(healthy control,HC)组。比较PD组与HC组脑部核团DKI参数中的平均扩散峰度(mean kurtosis,MK)、轴向扩散峰度(axial kurtosis,Ka)、径向扩散峰度(radial kurtosis,Kr)、平均扩散率(mean diffusivity,MD)、平行扩散系数(axial diffusivity,Da)、垂直扩散系数(radial diffusivity,Dr)、各向异性分数(fractional anisotropy,FA)值,及其与简易智力状态检查(Mini-mental State Examination,MMSE)量表评分的相关性。结果两组观察对象DKI参数中,除红核的Ka值、丘脑的Kr值、壳核的Kr值、苍白球的Kr值外,红核、黑质、丘脑、壳核、苍白球、尾状核的其他DKI参数差异具有统计学意义(P<0.05)。PD患者红核黑质MK值受试者工作特征(receiver operating characteristic,ROC)曲线下面积(area under the curve,AUC)最大,其次为黑质MD值、黑质Ka值、黑质Dr值、红核MK值,其AUC分别为1.000、0.992、0.818、0.808和0.791。各DKI参数与MMSE量表评分的相关性分析中,黑质MK值(r=0.572,P=0.043)和MD值(r=0.827,P=0.039)、红核MK值(r=0.738,P=0.042)和MD值(r=0.899,P=0.031)与MMSE量表评分具有正相关性,其他DKI参数值与MMSE量表评分之间无显著的相关性。结论DKI技术可应用于PD的诊断,且黑质DKI参数可作为PD的鉴别诊断及指导病情程度的优先指标。Objective:To explore the value of diffusion kurtosis imaging(DKI)in the early diagnosis of Parkinson's disease(PD).Materials and Methods:Fifty patients with PD diagnosed by PD specialty in our hospital from January 2018 to June 2021 were randomly selected as PD group,and 50 healthy people who came to our hospital for physical examination at the same time were selected as healthy control(HC)group.The mean kurtosis(MK)value,axial kurtosis(Ka)value,radial kurtosis(Kr)value,mean diffusivity(MD)value,axial diffusivity(Da)value,radial diffusivity(Dr)value and fractional anisotropy(FA)value of brain nuclei DKI parameters in PD group and HC group were compared,and the correlation with Mini-mental State Examination(MMSE)score was compared.Results:Except the Ka value of the red nucleus,the Kr value of the thalamus,putamen and globus pallidus,the other DKI parameters of the red nucleus,substantia nigra,thalamus,putamen,globus pallidus and caudate nucleus among the DKI parameters of the two groups were significantly different(P<0.05).The area under the curve(AUC)of the MK value of the red nucleus and substantia nigra in PD patients is the largest,followed by the MD value of substantia nigra,Ka value of substantia nigra,Dr value of substantia nigra and MK value of red nucleus according to the area under the curve(AUC).The AUC were 1.000,0.992,0.818,0.808 and 0.791,respectively.The correlation analysis between DKI parameters and MMSE score showed that MK value of substantia nigra(r=0.572,P=0.043)and MD value(r=0.827,P=0.039),MK value of red nucleus(r=0.738,P=0.042)and MD value(r=0.899,P=0.031)are positively correlated with MMSE score,and there was no significant correlation between other DKI parameters and MMSE score.Conclusions:The DKI can be used in the diagnosis of PD,and the parameters of substantia nigra DKI can be used as a priority index for the differential diagnosis of PD and guiding the severity of PD.

关 键 词：扩散峰度成像 帕金森病 平均扩散峰度 轴向扩散峰度 径向扩散峰度 平均扩散率 平行扩散系数 垂直扩散系数 各向异性分数 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.16[医药卫生—诊断学]