基于SyMRI弛豫定量分析和QSM预测早期帕金森病患者脑黑质微结构变化的临床价值研究  

Clinical value in predicting the microstructural alterations of substantia nigra in patients with early Parkinson's disease based on SyMRI relaxation quantitative analysis and QSM

作　　者：方子榕 陈秋雁 叶灵 余波 黄财城 余燕武 FANG Zirong;CHEN Qiuyan;YE Ling;YU Bo;HUANG Caicheng;YU Yanwu(Department of Radiology,the Affliated Ningde Municipal Hospital of Ningde Normal University,Ningde 352100,China;Department of neurology,The Affliated Ningde Municipal Hospital of Ningde Normal University,Ningde 352100,China)

机构地区：[1]宁德师范学院附属宁德市医院放射科,宁德352100 [2]宁德师范学院附属宁德市医院神经内科,宁德352100

出　　处：《磁共振成像》2024年第8期110-116,138,共8页Chinese Journal of Magnetic Resonance Imaging

基　　金：宁德师范学院校级专项资助计划科研项目(编号:2023ZX709)。

摘　　要：目的探讨合成磁共振成像(synthetic magnetic resonance imaging,SyMRI)和定量磁化率成像(quantitative susceptibility mapping,QSM)在预测早期帕金森病(Parkinson's disease,PD)脑黑质(substantia nigra,SN)微结构变化的临床应用价值。材料与方法前瞻性纳入于我院就诊的Hoehn-Yahr分级为1~2.5级的30例早期PD受试者并作为PD组,同时选取30例健康受试者作为健康对照(healthy control,HC)组。所有受试者均行颅脑SyMRI和QSM扫描。提取SyMRI弛豫定量图和QSM图,测量各定量图SN的T1值、T2值、质子密度(proton density,PrD)值和QSM值。采用独立样本t检验或Mann-Whitney U检验比较PD组与HC组SN的T1值、T2值、PrD值、QSM值的组间差异;绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析各定量参数及联合诊断模型的诊断效能;采用DeLong检验比较曲线下面积(area under the curve,AUC)的差异;采用Spearman相关系数分析PD组SN的各个弛豫定量值与QSM值的相关性。结果PD组与HC组SN的组间T1值、T2值、PrD值、QSM值差异有统计学意义(P<0.001)。T1值、T2值、PrD值、QSM值以及T1-T2-PrD-QSM联合诊断模型鉴别PD组和HC组的AUC值分别为0.872、0.788、0.749、0.838和0.930。T2值与联合诊断模型、PrD值与联合诊断模型、QSM值与联合诊断模型的AUC值差异有统计学意义(P值分别为0.007、0.004、0.034);T1值与QSM值呈正相关(r=0.436,P=0.016),T2值与QSM值呈负相关(r=-0.364,P=0.048),PrD值与QSM值呈负相关(r=-0.393,P=0.032)。结论基于SyMRI和QSM在SN的定量分析对诊断早期PD具有良好的诊断价值,能够为早期PD SN微结构变化提供不同的定量反馈,并且弛豫定量值和QSM值的联合诊断模型能够使诊断效能进一步提升,可为早期PD的诊断提供客观、定量的影像学指标。Objective:To investigate the clinical application value of synthetic magnetic resonance imaging(SyMRI)and quantitative susceptibility mapping(QSM)in predicting microstructural alterations of substantia nigra(SN)in early Parkinson's disease.Materials and Methods:A total of thirty early Parkinson's disease(PD)patients with Hoehn-Yahr stages ranging from 1 to 2.5 were prospectively recruited from our hospital and assigned to the PD group,and simultaneously selected 30 healthy subjects as the healthy control(HC)group.All subjects underwent brain SyMRI and QSM scanning.The SyMRI relaxation quantitative maps and QSM maps were extracted,and the T1,T2,proton density(PrD)and QSM values of SN in each quantitative maps were measured.Independent samples t test or Mann-Whitney U test was used to compare the differences in T1,T2,PrD and QSM values of SN between PD group and HC group.Receiver operating characteristic(ROC)curve was plotted to analyze the quantitative parameters as well as a diagnostic efficiency of the joint diagnostic model.The differences of area under the curve(AUC)values were compared by DeLong test.Spearman correlation coefficient was used to analyze the correlation between various relaxation quantitative values and QSM value in PD group.Results:There were significant differences in T1,T2,PrD and QSM values between PD group and HC group(P<0.001).The AUC values for T1,T2,PrD,QSM and T1-T2-PrD-QSM joint diagnostic model in distinguishing PD group from HC group were 0.872,0.788,0.749,0.838 and 0.930.There were statistically significant differences in AUC values between T2 value and joint diagnostic model,PrD value and joint diagnostic model,QSM value and joint diagnosis model(P=0.007,0.004,0.034).T1 values were positively correlated with QSM values(r=0.436,P=0.016),T2 values were negatively correlated with QSM values(r=-0.364,P=0.048),and PrD values were negatively correlated with QSM values(r=-0.393,P=0.032).Conclusions:Quantitative analysis of SN based on SyMRI and QSM demonstrates promising diagnostic value

关 键 词：帕金森病 黑质 磁共振成像 合成磁共振成像 定量磁化率成像 

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]