豆状核质子磁共振波谱对帕金森病的诊断价值

Diagnostic value on pronton magnetic resonance spectroscopy of lentiform nucleus in Parkinson disease

目的探讨质子磁共振波谱(1H-MRS)在帕金森病(PD)诊断中的临床应用价值。方法对19例临床确诊PD患者(PD组)和12例年龄相匹配的健康人(对照组)行1H-MRS检查,分析豆状核N-乙酰天冬氨酸/肌酸(NAA/Cr)和胆碱/肌酸(Cho/Cr)比值的变化,同时应用统一帕金森病评分量表(UPDRS)对PD患者进行评分,将UPDRS与豆状核代谢物比值进行相关性分析。结果PD组豆状核NAA/Cr比值显著低于对照组相应感兴趣区1.441±0.138vs1.551±0.837(P<0.05),Cho/Cr比值与对照组差异无统计学意义,PD组豆状核症状严重侧与对侧NAA/Cr比值及Cho/Cr比值差异无统计学意义,豆状核区代谢物比值与UPDRS评分无明显相关性。结论1H-MRS是一种能够反映PD神经病理学变化的无创技术,在PD临床诊断中具有一定临床价值。

Objective Evaluating the diagnostic value on pronton magnetic resonance spectroscopy（^1H-MRS） in Parkinson disease（PD）. Methods Proton magnetic resonance spectroscopy localized to the lentiform nucleus and clinical evaluation by unified PD rating scale（UPDRS） were carried out in 19 patients with PD and 12 healthy agematched controls, to evaluate whether there was a specific correlation between metabolic changes and the clinical findings. Results The N-acetylaspartate/creatine（NAA/Cr） peak ratio in the lentiform nucleus in PD group was significantly reduced as compared to that of control group, 1. 441±0. 138 vs 1. 551±0. 837（ P 〈0.05）;no significant difference was found in choline/creatine（Cho/Cr） ratio in PD group compared to control. There were no significant differences in ratios between the ipsilateral and contralateral to the worst affected side. The metabolic changes in the lentiform nucleus did not correlate well with the severity of PD. Conclusion ^1H-MRS is a noninvasive technique that can help to understand the pathogenesis of PD but may be not a useful indicator correlated with the severity of clinical findings in PD.