联合酰胺质子转移成像和定量磁化率成像在帕金森病诊断中的应用价值  

Application value of amide proton transfer combined with quantitative susceptibility mapping in the diagnosis of Parkinson's disease

作　　者：侯鹏飞 韩雪 王红[1] 琚超 张福兰 郝璐[1] HOU Pengfei;HAN Xue;WANG Hong;JU Chao;ZHANG Fulan;HAO Lu(Department of Radiology,The Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学第二附属医院影像科,新疆乌鲁木齐830000

出　　处：《分子影像学杂志》2024年第3期225-230,共6页Journal of Molecular Imaging

基　　金：国家重点实验室开放课题项目(SKL-HIDCA-2022-NKX7)。

摘　　要：目的 探讨酰胺质子转移成像(APT)和定量磁化率成像(QSM)对帕金森病(PD)诊断的临床应用价值。方法 纳入2022年6月~2023年6月新疆医科大学第二附属医院明确诊断为PD的患者38例作为PD组,另招募同时期相匹配的健康志愿者22例作为对照(HC)组。对所有受试者进行QSM和APT序列扫描,利用后处理软件获取所有受试者黑质区域的磁化率值(MSV)及非对称性磁化转移率(MTRasym),利用Logistic回归建模两种参数联合诊断时的预测概率,采用ROC曲线比较分析单一成像技术及两种成像技术联合的诊断效能。结果 对比HC组,PD组双侧黑质的平均MSV值升高,平均MTRasym值减低,差异有统计学意义(P<0.001)。运动症状受影响较重侧黑质的MSV值高于受影响较轻侧(P<0.001),运动症状受影响较重侧黑质的MTRasym值低于受影响较轻侧(P<0.05)。使用双侧黑质MSV和MTRasym的平均值,APT、QSM以及QSM联合APT的ROC曲线下面积分别为0.812、0.873、0.897,使用运动症状受影响较重侧黑质的MSV和MTRasym值,QSM联合APT的ROC曲线下面积为0.928。结论 QSM和APT对PD均具有较高的诊断效能,与单独使用QSM或APT相比,QSM联合APT对PD的诊断效能更高,能够为PD的准确诊断提供影像学依据。Objective To explore the clinical application value of amide proton transfer(APT) and quantitative susceptibility mapping(QSM) for the diagnosis of Parkinson's disease(PD).Methods A total of 38 patients who were diagnosed with PD in the Second Affiliated Hospital of Xinjiang Medical University from June 2022 to June 2023 were included as the PD group,and22 matched healthy control volunteers were recruited during the same period.QSM and APT images of all subjects were collected.The magnetic susceptibility value(MSV) and magnetization transfer asymmetry(MTRasym) of the substantia nigra region were obtained.The prediction probability of the combined diagnosis of two kinds of parameters was modeled by Logistics regression,and the diagnostic efficiency of the single imaging technology and the combined diagnosis of two kinds of imaging technology was compared by the ROC curve.Results Compared with the healthy control group,the average MSV value of substantia nigra in the PD group was significantly higher,while the average MTRasym value of substantia nigra in the PD group was significantly lower(P<0.001).MSV value of substantia nigra on the more heavily affected side was higher than that on the less lightly affected side(P<0.001),and MTRasym value of substantia nigra on the more heavily affected side was lower than that on the less lightly affected side(P<0.05).Using the average values of bilateral substantia nigra,the area under the ROC curve of APT,QSM and QSM combined with APT were 0.812,0.873,0.897.While using the values of the more affected side,the area under the ROC curve of QSM combined with APT was 0.928.Conclusion Both QSM and APT have high diagnostic efficacy for PD.QSM combined with APT has higher diagnostic efficacy for PD compared with QSM or APT alone and can provide an imaging basis for accurate diagnosis of PD.

关 键 词：帕金森病 磁共振成像 定量磁化率成像 酰胺质子转移成像 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]