帕金森病的MRI应用价值的研究

Study on applying value of MRI in Parkinson's disease

目的：探讨帕金森病（Parkinson＇s disease，PD）常规MRI的影像学表现特点和在常规MRI上测量黑质致密带（pars compacta of substantia nigra，SNc）宽度对PD的评估价值。方法：对90例PD患者（Hoehn-Yahr分级为Ⅰ-Ⅱ级57例、Ⅲ级18例、Ⅳ级15例）、60例年龄匹配的健康对照者进行MRI检查，分析PD患者的常规MRI影像学表现，对比分析PD组和对照组中MRI的白质高信号（包括侧脑室周围和半卵圆中心的白质高信号）的发生率，并对比分析PD组和对照组的SNc宽度。结果：PD组比对照组侧脑室周围白质高信号的发生率明显增高（P〈0．01），但PD组的半卵圆中心白质高信号的发生率与对照组无明显差异；PD组比对照组SNc宽度明显变窄，并且PD患者随病情加重其SNc宽度更加变窄。结论：PD常规MRI的影像学表现不具有诊断上的特异性，但在常规MRI上侧脑室周围白质高信号的观察和SNc宽度的测量对PD的评估具有临床应用价值。

Objective： To explore the features of MRI and the evaluation value of the width of substantia nigra compacta（SNc） measured by routine MRI in Parkinson＇s disease（PD）. Methods： 90 patients with PD（57 patients with Hoehn- Yahr stage Ⅰ-Ⅱ, 18 patients, Ⅲ, and 15 patients, Ⅳ） and 60 age - matched healthy controls were detected by MRI, the frequency d the white matter hyperintensities（including pefiventricular hyperintensities and centrum semiovale hyperintensities）, and the width of SNc on MRI were analyzed and compared. Results： The frequency of the periventricular hyperintensities were significantly higher in patients with PD than that in healthy controls（P〈0.01 ）. However, no significant differences in the frequency of centrum semiovale hyperintensities were found between patients with PD and healthy controis. Moreover, the width of SNc in patients with PD were closely related to the stage of PD（P〈0.01 ） ,the higher the stage of PD was,the less the width of SNc was（ P〈0.01 ）. Conclusion： The imaging changes of MRI have not specific diagnostic value in PD, but observation of periventricular hyperintensifies and measurement of the width of SNc on routine MRI are reliable to evaluate PD.