磁共振SWI在鉴别诊断原发性帕金森病和血管性帕金森综合征的应用价值  

作　　者：胡成一[1] 何康[1] 钱琦[1] 姜黄维[1] 林敏[1] 

机构地区：[1]浙江中医药大学附属第三医院,310000

出　　处：《浙江临床医学》2024年第11期1652-1654,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2020KY677);教育部产学合作协同育人项目(202102242023)。

摘　　要：目的探讨磁共振(MRI)磁敏感加权成像(SWI)在鉴别诊断原发性帕金森病(PD)和血管性帕金森综合征(VP)中的应用价值。方法回顾性分析2020年6月至2022年6月本院收治的原发性帕金森病患者30例和血管性帕金森综合征患者30例,同时纳入同期健康体检者30例为对照组,所有研究对象均接受MRI SWI扫描,分别测量各组黑质致密带宽度(WPCSN)、中脑直径以及WPCSN与中脑直径比值,并观察黑质致密部背外侧部“燕尾征”显示情况,评估其在鉴别PD和VP的应用价值。结果PD组的WPCSN和WPCSN/中脑直径比值明显小于VP组和对照组,差异有统计学意义(P<0.05),VP组的WPCSN和WPCSN/中脑直径比值也小于对照组,差异有统计学意义(P<0.05),而三组间中脑直径对比无显著差异(P>0.05)。在PD患者中,26例未显示“燕尾征”,VP患者中,9例未显示“燕尾征”,卡方检验结果显示差异有统计学意义(P<0.05)。结论MRI SWI在鉴别PD与VP中显示出一定的临床应用价值。Objective To explore the application value of magnetic resonance imaging(MRI)susceptibility weighted imaging(SWI)in the differential diagnosis of primary Parkinson's disease(PD)and vascular parkinsonism(VP).Methods A retrospective analysis was conducted on 30 patients with primary PD and 30 patients with VP admitted to our hospital from June 2020 to June 2022.Additionally,30 healthy individuals who underwent physical examination during the same period were included as a control group.All subjects underwent MRI SWI scanning,and the width of the substantia nigra pars compacta(WPCSN),midbrain diameter,and the ratio of WPCSN to midbrain diameter were measured.The presence or absence of the"swallow-tail sign"in the dorsal lateral part of the substantia nigra was observed to assess its application value in differentiating PD and VP.Results The WPCSN and the ratio of WPCSN to midbrain diameter in the PD group were significantly smaller than those in the VP group and the control group(P<0.05).The WPCSN and the ratio of WPCSN to midbrain diameter in the VP group were also smaller than those in the control group(P<0.05).However,there was no significant difference in midbrain diameter among the three groups(P>0.05).Among PD patients,the"swallow-tail sign"was absent in 26 cases,and in VP patients,it was absent in 9 cases.The chi-square test showed that the difference was statistically significant(P<0.05).Conclusion MRI SWI shows certain clinical application value in differentiating PD from VP.

关 键 词：原发性帕金森病 血管性帕金森综合征 磁敏感加权成像 

分 类 号：R742.5[医药卫生—神经病学与精神病学]