复发缓解型多发性硬化患者黑质亚区的定量磁化率成像研究  

Quantitative susceptibility mapping of the substantia nigra subregions in relapsing-remitting multiple sclerosis patients

作　　者：殷菲悦 李咏梅[1] 丁爽 向雅芸 祝琦源 王小花 谭泽昀 冯金洲[3] 曾春[1] Yin Feiyue;Li Yongmei;Ding Shuang;Xiang Yayun;Zhu Qiyuan;Wang Xiaohua;Tan Zeyun;Feng Jinzhou;Zeng Chun(Department of Radiology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Radiology,the Children′s Hospital of Chongqing Medical University,Chongqing 400015,China;Department of Neurology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院放射科,重庆400016 [2]重庆医科大学附属儿童医院放射科,重庆400015 [3]重庆医科大学附属第一医院神经内科,重庆400016

出　　处：《中华放射学杂志》2023年第6期632-639,共8页Chinese Journal of Radiology

基　　金：重庆市科学技术局技术创新与应用发展重点项目(CSTC2021-jscx-gksb-N0008);重庆市科卫联合医学科研重点项目(2023ADXM006)。

摘　　要：目的探讨定量磁化率成像(QSM)评价不同病程的复发缓解型多发性硬化(RRMS)患者黑质(SN)亚区铁沉积的分布情况和燕尾征改变情况。方法回顾性分析2019年11月至2021年12月在重庆医科大学附属第一医院确诊为53例RRMS患者(病例组)的临床及影像资料。病例组根据病程分为0~5年亚组、6~10年亚组、>10年亚组;另招募同期年龄、性别相匹配的37名健康志愿者作为对照组。所有受检者均接受MRI和QSM重建。首先在QSM上将SN分为头端腹侧、头端背侧、尾端腹侧、尾端背侧四个亚区,测量各亚区的磁化率值(QSV),然后在后处理生成的磁敏感加权图像上观察SN燕尾征改变情况及评分。采用方差分析比较各组别患者SN各亚区QSV值的差异,采用χ^(2)检验比较各组存在异常燕尾征概率。采用Spearman检验分析SN各亚区QSV值与燕尾征评分的相关性。结果RRMS患者0~5年亚组、6~10年亚组、>10年亚组及对照组的SN头端腹侧、头端背侧、尾端腹侧、尾端背侧的QSV值差异具有统计学意义(P<0.05)。RRMS患者0~5年亚组较对照组SN头端腹侧、头端背侧、尾端腹侧QSV值均增加(P分别为0.039、0.008、0.039);6~10年亚组较0~5年亚组SN头端腹侧、尾端腹侧、尾端背侧QSV值增加(P分别为<0.001、0.020、0.015);>10年亚组SN尾端腹侧、尾端背侧QSV值均低于6~10年亚组(P=0.037、0.006);>10年亚组头端腹侧、头端背侧QSV值大于对照组(P分别为<0.001、0.001)。RRMS患者0~5年亚组中7例存在异常燕尾征,6~10年亚组中11例存在异常燕尾征,>10年亚组中12例存在异常燕尾征,对照组中9例存在异常燕尾征;病例组各亚组及对照组异常燕尾征概率差异有统计学意义(χ^(2)=16.20,P=0.011)。6~10年亚组、>10年亚组RRMS患者SN燕尾征评分与SN尾端背侧QSV值呈正相关(rs=0.65,P=0.006;rs=0.48,P=0.045)。结论0~5年亚组RRMS患者铁沉积集中于SN头端腹侧、头端背侧及尾端腹侧,6~10年亚组集中Objective To investigate the distribution of iron deposition in the substantia nigral(SN)subregions on quantitative susceptibility mapping(QSM)and the change of swallow tail sign(STS)in patients with relapsing-remitting multiple sclerosis(RRMS)of different disease stages.Methods The clinical and imaging data of 53 patients with RRMS(case group)diagnosed at the First Hospital of Chongqing Medical University from November 2019 to December 2021 were retrospectively analyzed.The case group was divided into 0-5 years subgroup,6-10 years subgroup,and>10 years subgroup according to the disease duration;another 37 age-and gender-matched healthy volunteers were recruited as the control group during the same period.All subjects underwent MRI and QSM reconstruction.First,the SN was divided into four subregions:rostral anterior-SN(aSNr),rostral posterior-SN(pSNr),caudal anterior-SN(aSNc),and caudal posterior-SN(pSNc)on the QSM,and the quantitative susceptibility value(QSV)of each subregion was measured,and then the STS of the SN was observed and scored on the susceptibility weighted imaging(SWI)generated by post-processing.ANOVA was used to compare the differences in the QSV of each subregion of SN among the groups,and the probability of abnormal STS was compared using theχ^(2) test.Spearman′s test was used to analyze the correlation between the QSV of each subregion of SN and the STS score.Results The differences in QSV of aSNr,pSNr,aSNc,and pSNc were statistically significant among the 0-5 years subgroup,6-10 years subgroup,>10 years subgroup of RRMS patients and the control group(P<0.05).The QSV of aSNr,pSNr,and aSNc in 0-5 years subgroup was higher than those in the control group(P was 0.039,0.008,0.039,respectively).The QSV of aSNr,aSNc,and pSNc in the 6-10 years subgroup were higher than those in the 0-5 years subgroup(P was<0.001,0.020,0.015,respectively).The QSV of the aSNc,pSNc in>10 years subgroup were lower than those in the 6-10 years subgroup(P=0.037,0.006).The QSV of aSNr,pSNr in>10 years subgroup were highe

关 键 词：多发性硬化 定量磁化率成像 黑质 铁 燕尾征 

分 类 号：R744.51[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]