MRI联合交感皮肤反应及经颅超声诊断帕金森病与多系统萎缩P型的研究  

Study on the diagnosis of Parkinson’s disease and multiple system atrophy type P by conventional MRI combined with sympathetic skin response and transcranial ultrasound

作　　者：徐天阳 刘恒方[1] 郭亚培[1] 石磊[1] 张敏[1] 李金凤 XU Tianyang;LIU Hengfang;GUO Yapei;SHI Lei;ZHANG Min;LI Jinfeng(The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第五附属医院,河南郑州450052

出　　处：《中国实用神经疾病杂志》2024年第4期403-408,共6页Chinese Journal of Practical Nervous Diseases

基　　金：河南省科技攻关计划项目(编号:LHGJ20190413)。

摘　　要：目的 探讨头部常规磁共振(MRI)联合交感神经皮肤反应(SSR)及经颅超声成像(TCS)用于诊断帕金森病(PD)与多系统萎缩P型(MSA-P型)的价值。方法 收集2019-01—2022-06郑州大学第五附属医院临床确诊且具有完整资料的22例MSA-P型患者和29例PD患者,均行头部常规MRI、SSR和TCS检查,采用ROC曲线评价头部MRI、SSR和TCS诊断MSA-P型和PD患者的临床价值。结果 壳核裂隙征具有影像特异性,MSA-P型组远高于PD组(P<0.05)。MSA-P型组上、下肢SSR平均起始潜伏期延长,平均波幅降低与PD组比较差异有统计学意义(P<0.01)。2组黑质强回声面积、黑质强回声总面积与中脑总面积比值比较差异有统计学意义(P<0.01)。ROC曲线下壳核裂隙征有高特异性(96.8%),SSR上肢潜伏期有高敏感性(88.2%),SN强回声面积诊断价值最高,曲线下面积(AUC)为0.881;头部MRI联合SSR、TCS用于预测两种疾病的敏感度为72.1%,AUC为0.913。结论 分析头部MRI检查结果,早期进行SSR、TCS检查可提高对MSA-P型与PD患者的诊断率。Objective To analyze the value of conventional magnetic resonance imaging(MRI)combined with sympathetic skin response(SSR)and transcranial sonography(TCS)in the diagnosis of Parkinson’s disease(PD)and multiple system atrophy type P(MSA-P).Methods A total of 22 patients with MSA-P and 29 patients with PD who were clinically diagnosed and had complete data in the Fifth Affiliated Hospital of Zhengzhou University from January 2019 to June 2022 were collected.All patients underwent head conventional MRI,SSR and TCS.ROC curve was used to evaluate the clinical value of head MRI,SSR and TCS in the diagnosis of MSA-P and PD patients.Results The putaminal slit sign was more specific in MSA-P group than that in PD group(P<0.05).The average onset latency of SSR in upper and lower limbs in MSA-P group was significantly longer than that in PD group(P<0.01),and the average amplitude was significantly lower than that in PD group(P<0.01).There were significant differences in the substantia nigra hyperechoic area and the ratio of the total substantia nigra hyperechoic area to the total midbrain area between the two groups(P<0.01).ROC curve showed that putaminal slit sign had high specificity(96.8%),SSR upper limb latency had high sensitivity(88.2%),SN hyperecho area had the highest diagnostic value,the area under the curve(AUC)was 0.881.The sensitivity of head MRI combined with SSR and TCS to predict the two diseases was 72.1%,and the AUC was 0.913.Conclusion Analyzing the results of head MRI examination,early SSR and TCS examination can improve the diagnosis rate of MSA-P and PD patients.

关 键 词：交多系统萎缩-P型 帕金森病 感神经皮肤反应 常规磁共振 经颅超声成像 

分 类 号：R742.1[医药卫生—神经病学与精神病学]