黑质亚区定量磁化率成像在帕金森病诊断中的价值  

Quantitative susceptibility mapping of the substantia nigra subregions in diagnosis of Parkinson′s disease

作　　者：付芳琴 邹语嫣 康嗣如 缴春悦 刘绪纶 赵瑜 田荣华[1] FU Fang-qin;ZHOU Yu-yan;KANG Si-ru(Department of Medical Imaging,Xiaogan Hospital Affiliated to Wuhan University of Science and Technology,Hubei 432000,China)

机构地区：[1]武汉科技大学附属孝感医院影像科,湖北孝感432000 [2]武汉科技大学医学部医学院,湖北武汉430065 [3]锦州医科大学孝感市中心医院培养基地,湖北孝感432000

出　　处：《放射学实践》2024年第12期1565-1571,共7页Radiologic Practice

摘　　要：目的:应用定量磁化率成像(QSM)分析帕金森病(PD)患者黑质亚区磁化率值(QSV)的变化及其诊断价值。方法:将2021年9月-2024年3月在本院神经内科就诊的36例PD患者(PD组)和22例健康对照者(HC组)纳入本研究,所有受试者行常规MRI和QSM扫描,经后处理得到QSM图和真实磁敏感加权成像(tSWI)图。在QSM图上在黑质(SN)的头端腹侧、头端背侧、尾端腹侧和尾端背侧四个亚区分别手动勾画ROI并测量QSV值;在tSWI图上观察燕尾征并进行评分(0~1分)。比较两组间各SN亚区QSV值的差异、比较两组内SN尾端与头端的差异,并采用受试者操作特征(ROC)曲线评估各SN亚区QSV值、燕尾征评分独立及两者联合应用对PD的诊断效能。采用Spearman相关分析评估QSV值与PD病程及燕尾征评分的相关性。结果:PD组SN整体、SN头端(头端腹侧、头端背侧)和SN尾端(尾端腹侧、尾端背侧)的QSV值均显著高于HC组(P<0.05)。两组中SN尾端的QSV值均显著高于头端(P<0.05)。ROC曲线分析显示,SN尾端背侧QSV值与燕尾征评分联合应用诊断PD的AUC(95%CI)、敏感度和特异度分别为0.941(0.882~1.000)、94.4%和86.4%,其诊断效能明显高于尾端背侧QSV值(AUC=0.833)和燕尾征评分(AUC=0.876)独立应用,差异具有统计学意义(P<0.05)。SN尾端及尾端背侧QSV值与病程(r=0.345,P<0.05;r=0.358,P<0.05)和燕尾征评分均呈正相关(r=0.379,P<0.05;r=0.411,P<0.05)。结论:PD患者与健康受试者SN亚区QSV值存在差异,PD患者SN尾端的QSV值高于头端,且其与病程存在一定相关性,SN尾端背侧QSV值与燕尾征评分联合应用对PD的诊断价值更高。Objective:To analyze the difference of SN subregions quantitative susceptibility value(QSV)and the value in the diagnosis of Parkinson′s disease(PD)based on quantitative susceptibility mapping(QSM).Methods:36 PD patients(PD group)and 22 healthy control group(HC group)diagnosed in our hospital from September 2021 to March 2024 were included.All subjects underwent MR and QSM scans.QSM and true SWI(tSWI)were obtained after post-processing.In the QSM,SN was divided into four subregions:rostral anterior-SN(aSNr),rostral posterior-SN(pSNr),caudal anterior-SN(aSNc),caudal posterior-SN(pSNc),and the QSV were recorded.The swallow-tail sign was observed and scored(0~1)on the tSWI.The inter-group differences of QSV of SN subregions between the two groups were compared.The intra-group differences of QSV of rostral SN and caudal SN were compared.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficiency of SN subregions QSV and swallow-tail sign score independently and in combination.Spearman correlation analysis was used to analyze the correlation between QSV and PD disease duration and swallow-tail sign score.Results:Compared with HC group,the QSV of SN,rostral SN(aSNr and pSNr)and caudal SN(aSNc and pSNc)in PD group were increased(P<0.05).The QSV of caudal SN was higher than rostral SN in PD group and HC group(P<0.05).ROC analysis showed that AUC(95%CI),sensitivity and specificity of combined application of the QSV of pSNc and the swallow-tail sign score in diagnosing PD were 0.941(0.882~1.000),94.4%and 86.4%,respectively.The AUC was significantly higher than that of single application of the QSV of pSNc(AUC=0.833)and the swallow-tail sign score(AUC=0.876),and the difference was statistically significant(P<0.05).The QSV of caudal SN and pSNc were positively correlated with the course of disease(r=0.345,P<0.05;r=0.358,P<0.05)and swallow tail sign score(r=0.379,P<0.05;r=0.411,P<0.05).Conclusion:There are differences in QSV values of SN sub-regions between PD patients and healthy subjects.The

关 键 词：帕金森病 定量磁化率成像 磁化率 黑质 燕尾征 

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]