联合酰胺质子转移成像与定量磁敏感图成像技术在不同分期帕金森病患者中的初步探究  

Preliminary study on different stages of Parkinson's Disease combined with amide proton transfer imaging and quantitative susceptibility mapping

作　　者：杨晨 廖琪[1,2] 琚超 王红 郝璐[1] YANG Chen;LIAO Qi;JU Chao;WANG Hong;HAO Lu(Department of Medical Imaging Center,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830063,China;Xinjiang Medical University,Urumqi 830063,China)

机构地区：[1]新疆医科大学第二附属医院影像中心,乌鲁木齐830063 [2]新疆医科大学,乌鲁木齐830063

出　　处：《磁共振成像》2024年第12期79-86,共8页Chinese Journal of Magnetic Resonance Imaging

基　　金：省部共建中亚高发病成因与防治国家重点实验室开放课题项目(编号:SKL-HIDCA-2022-NKX7)。

摘　　要：目的利用酰胺质子转移(amid proton transfer,APT)成像与定量磁敏感图(quantitative susceptibility mapping,QSM成像技术分析不同分期帕金森病(Parkinson's disease,PD)患者黑质(substantia nigra,SN)、红核(red nucleus,RN)、齿状核(dentate nucleus,DN)的APT加权(APT-weighted,APTw)成像值、磁化率值(magnetic susceptibility value,MSV)的差异,并与健康对照(healthy control,HC)组进行比较。探讨各核团APTw值与MSV能否作为判断PD不同分期的影像学指标。材料与方法收集来自新疆医科大学第二附属医院的35例PD患者以及24例性别、年龄与之相匹配的HC组,PD组根据Hoehn-Yahr分级分为早期PD(early-stagePD,ESPD)组22例(Hoehn-Yahr≤2)和中晚期PD(advanced-stagePD,ASPD)组13例(Hoehn-Yahr≥2.5)。对比各组不同部位核团APTw值与MSV差异。然后采用受试者工作特征(receiver operating characteristic,ROC)曲线分析APT、QSM及两者联合使用的诊断性能。最后观察各核团APTw值、MSV与临床量表的相关性。结果APTw值在ESPD组与HC组、ESPD组与ASPD组、ASPD组与HC组的SN间,ASPD组与HC组的RN间,ESPD组与HC组、ASPD组与HC组的DN间,差异具有统计学意义(P<0.05)。MSV在ESPD组与HC组、ESPD组与ASPD组、ASPD组与HC组的SN间,ASPD组与HC组、ASPD组与ESPD组的RN间,ASPD组与HC组、ASPD组与ESPD组的DN间,差异具有统计学意义(P<0.05)。APT、QSM及两者联合鉴别ESPD组与HC组的ROC曲线下面积(area under the curve,AUC)分别为0.886、0.792、0.926,差异具有统计学意义(P<0.05);在鉴别ESPD组与ASPD组的AUC分别为0.787、0.885、0.939,差异具有统计学意义(P<0.05)。SN的APTw值与MoCA评分呈正相关,SN、RN的MSV与MoCA评分呈负相关;SN、RN的APTw值与MMSE评分呈正相关,差异均具有统计学意义(P<0.05)。结论APT和QSM可作为评估PD分期的影像学指标,APT与QSM联合应用可显著提高诊断效能。Objective:To analyze the differences of amid proton transfer weighted(APTw)value and magnetic susceptibility value(MSV)of the substantia nigra dentate system between different stages of Parkinson's disease(PD)and healthy control(HC)by amid proton transfer(APT)and quantitative susceptibility mapping(QSM).To evaluate whether the APTw value or MSV in substantia nigra(SN),red nucleus(RN)and dentate nucleus(DN)could serve as imaging findings for determining different stages of Parkinson's disease.Materials and Methods:A total of 35 patients with PD and 25 HCs(age and sex matched)were recruited from the Second Affiliated Hospital of Xinjiang Medical University.The PD group was divided into an early-stage PD(ESPD)group of 22 cases and an advanced-stage PD(ASPD)group of 13 cases based on Hoehn-Yahr grading,then,comparing the differences between APTw values and MSV among different regions of nuclei in each group.Finally,the receiver operating characteristic(ROC)curves were used to analyze the diagnostic performance of APT,QSM,and their combined use.The receiver operating characteristic(ROC)curves and DeLong test were used to evaluate the efficiency of APT,QSM and combined parameters.Finally,the correlation of clinical scales with APTw values and MSV were analyzed.Results:The APTw values between the ESPD group and the HC group,the ESPD group and the ASPD group,the ASPD group and the HC group in the SN,between the ASPD group and the HC group in the RN,and between the ESPD group and the HC group,the ASPD group and the HC group in the DN show statistically significant differences(P<0.05).The MSV values between the ESPD group and the HC group,the ESPD group and the ASPD group,the ASPD group and the HC group in the SN,between the ASPD group and the HC group,the ASPD group and the ESPD group in the RN,and between the ASPD group and the HC group,the ASPD group and the ESPD group in the DN show statistically significant differences(P<0.05).The area under the curve(AUC)of APT,QSM,and their combination in distinguishing the ESPD gro

关 键 词：帕金森病 酰胺质子转移成像 定量磁敏感图 磁共振成像 分期 

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]