高清扩散加权成像对帕金森病患者脑深部灰质核团的价值研究  

Study on the ADC value of deep gray matter nuclei in patients with Parkinson’s disease by RESOLVE DWI

作　　者：朱黎淑 李信友[1] 郁斌[1] 陆云峰[1] 张志伟[1] 李咏梅[1] 吕发金[1] 杜思霖[1] ZHU Lishu;LI Xinyou;YU Bin;LU Yunfeng;ZHANG Zhiwei;LI Yongmei;LYU Fajin;DU Silin(Department of Radiology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院放射科,重庆400016

出　　处：《重庆医学》2025年第4期915-920,共6页Chongqing Medical Journal

基　　金：重庆医科大学附属第一医院院内培育基金项目(PYJJ2019-213)。

摘　　要：目的利用高清扩散加权成像(RESOLVE DWI)技术分析帕金森病(PD)患者脑深部灰质核团的表观弥散系数(ADC)值及其与临床特征的相关性。方法回顾性分析60例PD患者(PD组)的病历资料,按运动亚型分为震颤组(n=30)和运动迟缓组(n=30),按年龄分为中年组(≤65岁,n=23)和老年组(>65岁,n=37),并选择同期健康志愿者60名作为对照组。在RESOLVE DWI序列的ADC图上测量ADC值,分析双侧壳核、苍白球、黑质、红核、齿状核的ADC值差异及其与UPDRS-Ⅲ评分和H&Y分级的相关性。结果与对照组相比,PD组双侧壳核、苍白球、红核、齿状核及右侧黑质ADC值较高,震颤组双侧壳核、苍白球、红核,右侧黑质ADC值较高,运动迟缓组右侧壳核、苍白球及双侧红核ADC值较高(P<0.05)。震颤组与运动迟缓组比较,各核团的ADC值差异无统计学意义(P>0.05)。老年组右侧壳核、双侧苍白球、左侧黑质、左侧红核ADC值较中年组高(P<0.05)。在PD组中,右侧壳核、苍白球、齿状核ADC值与H&Y分级、UPDRS-Ⅲ评分呈正相关,左侧壳核ADC值与H&Y分级呈正相关。结论RESOLVE DWI可用于评价不同运动亚型PD患者脑深部灰质核团的差异,其ADC值可用于评估和预测PD患者核团受损及运动症状的严重程度。Objective Readout segmentation of long variable echo-trains diffusion weighted imaging(RESOLVE DWI)was used to analyze the difference of apparent diffusion coefficient(ADC)value in deep cerebral nucleus and its correlation with clinical characteristics in patients with Parkinson’s disease(PD).Methods Clinical data of 60 patients with PD were retrospectively analyzed as PD group,and were divided into the tremor group(n=30)and the bradykinesia group(n=30)according to symptom type,middle-aged(≤65 years old)group(n=23)and elderly(>65 years old)group(n=37)according to age,and 60 healthy volunteers were selected as the control group during the same period.ADC values were measured on the ADC map of RESOLVE DWI sequence,and the ADC values of bilateral putamen,pallidus,s ubstantia nigra,rubra,and dentate nucleus were analyzed and their correlation with UPDRS-Ⅲscore and H&Y grading.Results Compared with the control group,the ADC values of both putamen,globus pallidus,globus pallidus,red nucleus,right substantia nigra and right dentate nucleus were increased in the PD group,the ADC values of both putamen,globus pallidus,red nucleus and right substantia nigra in the tremor group were increased,and the ADC values of right putamen,globus pallidus and bilateral red nucleus in the bradykinesia group were increased(P<0.05).Compared with the bradykinesia group,the values of ADC in the tremor group were similar.Compared with the middle-aged group,the ADC values of right putamen,bilateral globus pallidus,left substantia nigra and left red nucleus were higher in the elderly group(P<0.05).In the PD group,the ADC values of the right putamen,globus pallidus,and dentate nucleus were positively correlated with H&Y grade and UPDRS-Ⅲscore,and the ADC value of the left putamen was positively correlated with H&Y grade.Conclusion RESOLVE DWI can be used to evaluate the differences in deep gray matter nuclei in PD patients,and its ADC value may be used to evaluate and predict the severity of nuclear mass damage and motor symptoms in PD

关 键 词：帕金森病 深部灰质核团 高清扩散加权成像 表观弥散系数 

分 类 号：R742.5[医药卫生—神经病学与精神病学]