7T磁共振磁敏感加权成像技术在帕金森病中的应用  

Application of 7T magnetic resonance susceptibility weighted imaging in Parkinson’s disease

作　　者：李凤珠 尹西[1] 段曹辉 王晓玉 王淼[1] 边祥兵[2] 娄昕[2] 高中宝[1] 王振福[1] Li Fengzhu;Yin Xi;Duan Caohui;Wang Xiaoyu;Wang Miao;Bian Xiangbing;Lou Xin;Gao Zhongbao;Wang Zhenfu(Department of Neurology,the Second Medical Center&National Clinical Research Center for Geriatric Disease,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心神经内科,国家老年疾病临床医学研究中心,北京100853 [2]解放军总医院第一医学中心放射诊断科

出　　处：《中华老年心脑血管病杂志》2023年第2期122-125,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(82151309);国家重点研发计划(2021YFC2501200);军队保健专项科研课题(21BJZ18)。

摘　　要：目的 通过7 T磁共振磁敏感加权成像技术分析帕金森病(PD)患者黑质铁沉积情况。方法 收集2021年12月至2022年8月解放军总医院PD门诊确诊的原发性PD患者18例(PD组),选取同期年龄和性别匹配的健康体检者18例(对照组)。用7 T磁敏感加权成像序列扫描获取相位图并测量相位值,分析PD患者Hoehn-Yahr(H-Y)分期、统一帕金森病评定量表(UPDRS)总分和Ⅰ、Ⅱ、Ⅲ评分、39项帕金森病生活质量问卷(PDQ-39)评分等资料。结果 与对照组比较,PD组黑质面积较大[(223.03±30.60)mm^(2)vs(202.08±27.47)mm^(2),P<0.05],而黑质相位值和致密部相位值明显降低[-0.03(-0.06,0.02)vs 0.04(-0.02,0.12),P<0.01;0.16±0.10 vs 0.26±0.12,P<0.01]。PD组H-Y分期、UPDRS总分和Ⅰ、Ⅱ、Ⅲ评分及PDQ-39评分与黑质及致密部相位值不相关(P>0.05)。PD组2、3、5层相位值较对照组明显降低[0.110(-0.009,0.226)vs 0.224(0.126,0.360),-0.022(-0.060,0.026)vs 0.042(-0.028,0.114),-0.112(-0.154,0.036)vs-0.030(-0.088,0.019),P<0.05]。结论 PD患者黑质铁沉积不均匀增加,体积增大,7 T磁敏感加权成像对PD有一定诊断价值。Objective To analyze the iron deposition in the substantia nigra(SN) in patients with Parkinson’s disease(PD) by 7 T magnetic resonance susceptibility weighted imaging(SWI).Methods Eighteen patients with confirmed idiopathic PD in PD Clinic of Chinese PLA General Hospital from December 2021 to August 2022 were recruited and served as PD group, and another 18 age-and gender-matched healthy subjects who taking physical examination during the same period served as a control group.High resolution SWI sequence was performed on a 7 T magnetic resonance imaging system to complete the phase map and measure the phase value.The Hoehn-Yahr(HY) stage, total score and Part Ⅰ,Ⅱ,and Ⅲ scores of unified Parkinson’s disease rating scale(UPDRS),and results of 39 items of Parkinson’s quality of life(PDQ-39) of the PD patients were collected and analyzed.Results The area of SN(223.03±30.60 mm^(2) vs 202.08±27.47 mm^(2),P<0.05) was significantly larger, while the overall phase value of the SN [-0.03(-0.06,0.02) vs 0.04(-0.02,0.12),P<0.01] and the phase value of the SN pars compacta(0.16±0.10 vs 0.26±0.12,P<0.01) were lower in the PD group than the control group.Pearson correlation analysis showed that disease duration, H-Y stage, UPDRS Part Ⅰ,Ⅱ,and Ⅲ scores and total score, and PDQ-39 scores had no significant correlations with the phase values of SN and SN pars compacta in the PD group(P>0.05).The phase values of layer 2, 3 and 5 in the PD group were significantly lower than those in the control group [0.110(-0.009,0.226) vs 0.224(0.126,0.360),-0.022(-0.060,0.026) vs 0.042(-0.028,0.114),-0.112(-0.154,0.036) vs-0.030(-0.088,0.019),P<0.05].Conclusion PD patients present larger area and unevenly increased iron deposition in the SN.7 T SWI is valuable in the diagnosis of PD.

关 键 词：磁共振成像 帕金森病 多巴胺能神经元 铁 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742.5[医药卫生—诊断学]