帕金森病脑铁沉积的定量研究

The Quantitative Study of Brain Iron Deposition in Parkinson's Disease

目的探讨定量研究脑铁沉积的磁共振检查方法;研究帕金森病（Parkinson’s disease,PD）的发病和进展与脑铁沉积的关系。方法PD患者30名作为研究组,男22名,女8名,平均年龄57.7岁（38-74岁）,按Hoehn-Yahr分级量表将双侧症状患者20名作为PD组1,单侧症状PD患者10名作为PD组2。选取年龄和性别匹配的健康志愿者30名作为对照组。所有对象均进行常规MR头部平扫和SWI检查,经后处理在相位校正图上分别测量双侧黑质、红核、苍白球、壳核、尾状核和丘脑的相位校正值（CP）,并将所获得数据进行统计分析。结果CP值与铁含量呈负线性相关（r=-2.81,P〈0.05）。PD组1、PD组2与对照组在以下核团（黑质、红核、苍白球和壳核）的CP值差异有统计学意义（P〈0.05）,但是在丘脑和尾状核差异无统计学意义。PD组1和PD组2各兴趣区CP值之间差异无统计学意义。PD组2的症状同侧和对侧之间CP值无明显差异。结论①CP值与脑铁含量呈负线性相关联;②局部铁含量的增加与PD的发病有关,但与病情的严重程度无关;③在PD的亚临床期就有铁异常沉积;④PD铁异常沉积的部位包括黑质、红核、苍白球和壳核,与丘脑和尾状核无关。

Objective To explore MR technology for the quantitative study of brain iron deposition,and investigate the relationship between Parkinson＇s Disease（PD） pathogenesis or progress and brain iron deposition.Methods Ten PD patients with unilateral symptoms and 20 PD patients with bi-lateral symptoms were enrolled in PD group 1 and PD group 2,respectively.Of the 30 PD patients,there were 22 males and 8 females with the average age being 57.7 years old（range： 38-74）.The patients in PD groups and 30 age-and sex-matched volunteers were subjected to the routine MR plain scan and SWI scan.The corrected phase（CP） values in substantia nigra,red nucleus,globus pallidus,putamen,caudate and thalamus were measured on CP images,and statistically analyzed.Results There was a negative linear correlation between CP values and brain iron deposition（r=-2.81,P〈0.05）.The CP values in substantia nigra,red nucleus,globus pallidus and putamen were significantly lower in PD groups（P〈0.05）.No significant difference was demonstrated in CP values in caudate and thalamus.No significant difference was found in CP values in all regions of interesting between PD group 1 and PD group 2.There was no significant difference in the CP values between the two sides in the PD group 2.Conclusion There was a negative linear correlation between CP values and brain iron deposition.The increase of brain iron deposition was related with PD pathogenesis,but not with the illness severity.There exists abnormal brain iron deposition before subclinical period in PD.The sites of pathologic iron deposition include substantia nigra,red nucleus,globus pallidus,putamen.