黑质、红核化学交换饱和转移成像定量指标在帕金森病中的研究  

Quantitative chemical exchange saturation transfer imaging of the substantia nigra and red nucleus in Parkinson disease

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作  者:李昕阳 田瑶天 苏闻[2] 李淑华[2] 李凯[2] 马欣昕[2] 郑丹丹 李春媚[1] 陈敏[1] Li Xinyang;Tian Yaotian;Su Wen;Li Shuhua;Li Kai;Ma Xinxin;Zheng Dandan;Li Chunmei;Chen Min(Department of Radiology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Neurology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730 China;Clinical and Technical Support,Philips(China)Investment Co.,Ltd.,Beijing 100600,China)

机构地区:[1]北京医院放射科、国家老年医学中心、中国医学科学院老年医学研究院,北京100730 [2]北京医院神经内科、国家老年医学中心、中国医学科学院老年医学研究院,北京100730 [3]飞利浦(中国)投资有限公司临床与技术支持部,北京100600

出  处:《中华放射学杂志》2024年第6期603-610,共8页Chinese Journal of Radiology

基  金:国家自然科学基金(82071891,81401404)。

摘  要:目的采用化学交换饱和转移(CEST)成像分析帕金森病(PD)患者双侧黑质、红核定量指标的改变,并探讨其临床应用价值。方法该研究为横断面研究。回顾性收集2012年12月至2015年7月在北京医院就诊的45例PD患者(PD组)和同期年龄、性别、认知功能相匹配的21名正常对照者(NC组)。所有受试者均接受头部常规MRI及CEST-MRI检查。基于MATLAB平台软件包,采用4池洛伦兹拟合模型方法,分析受试者双侧黑质、红核CEST成像的信号改变,获得相应的酰胺基(Amide)、核奥氏效应(NOE)、直接水饱和(DS)效应和半固体磁化转移(MT)效应值。采用独立样本t检验及Mann-Whitney U检验比较PD组、NC组双侧黑质、红核的CEST参数值,以Bonferroni校正控制多重比较;取校正后P<0.05的参数建立联合模型。以受试者操作特征曲线及曲线下面积(AUC)评估CEST参数及联合模型诊断PD的效能。结果与NC组相比,PD组左侧黑质Amide值、左侧红核Amide值、右侧黑质NOE值减低,差异有统计学意义(t=-3.59,校正P=0.026;t=-3.77,校正P=0.016;Z=-3.27,校正P=0.017)。左侧黑质Amide值、左侧红核Amide值、右侧黑质NOE值及联合模型均对PD具有较好的诊断效能(AUC分别为0.78、0.79、0.75、0.81),其中联合模型具有最高的AUC值(0.81)和最高的特异度(97.78%),左侧黑质Amide值具有最高的灵敏度(93.33%)。结论基于4池洛伦兹拟合模型的CEST成像技术量化分析显示PD组与NC组的黑质、红核部分CEST定量指标存在显著差异,在PD诊断中具有较好的临床应用潜力。Objective To investigate the change of chemical exchange saturation transfer(CEST)imaging in the bilateral substantia nigra(SN)and red nucleus(RN)of Parkinson disease(PD),and to explore the value of CEST-MRI for the clinical application of PD.Methods This was a cross-sectional study.A total of 45 PD patients(PD group)and 21 sex-,age-,and cognitive-function matched normal control subjects(NC group)were retrospectively enrolled from December 2012 to July 2015 in Beijing Hospital.All subjects underwent brain CEST-MRI and routine MRI.Based on the MATLAB software package,the 4-pool Lorentz fitting model was applied to analyze the signal change of CEST imaging,which could acquire the mean amplitudes of the 4-pool parameters including Amide,nuclear overhauser enhancement(NOE),direct water saturation(DS)and magnetization transfer(MT)in the bilateral SN and RN.Independent samples t test and Mann-Whitney U test were used to compare CEST parameters between the PD group and the NC group and controlled by Bonferroni correction.The combined model was constructed based on parameters with inter-group differences after correction.The receiver operating characteristic curve and area under the curve(AUC)were used to evaluate the diagnostic efficiency of the CEST parameters and the combined model.Results Compared with the NC group,the left SN Amide value,left RN Amide value,and right SN NOE value were reduced in the PD group,and the difference was statistically significant(t=-3.59,corrected P=0.026;t=-3.77,corrected P=0.016;Z=-3.27,corrected P=0.017).The left SN Amide value,the left RN Amide value,the right SN NOE value,and the combined model all had good diagnostic efficacy in the differentiation of the PD group from the HC group(AUCs of 0.78,0.79,0.75,and 0.81,respectively).The combined model had the highest AUC value(0.81)and specificity(97.78%),the Amide value of left SN had the highest sensitivity(93.33%).Conclusions Quantitative analysis of CEST-MRI based on the 4-pool Lorentz fitting model shows significant differences in the

关 键 词:帕金森病 磁共振成像 化学交换饱和转移 Z谱拟合 

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]

 

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