弥散张量成像对早期帕金森病的研究价值

Diffusion Tensor Imaging Study on Early Parkinson's Disease

目的:探讨弥散张量成像(DTI)对早期原发性单侧症状帕金森病(PD)的诊断价值,为临床诊断及疾病分级提供参考及依据。方法:26例未经治疗的早期原发性单侧症状帕金森病患者为PD组,20例健康正常人为对照组,对两组均进行常规磁共振(MRI)及DTI检查,检查前对PD组均进行UPDRS评分及Hoehn&Yahr分期,DTI测量双侧黑质、壳核、尾状核头部及丘脑的各向异性分数(FA值)及表观弥散系数(ADC值)。结果:PD组症状对侧黑质的FA值较同侧及对照组双侧均值显著减低(t=2.987,P=0.004;t=3.072,P=0.003),其余感兴趣区FA值及所有感兴趣区ADC值组内及组间均无明显差异;症状对侧黑质FA值与UPDRS评分无明显相关性。结论:单侧症状PD患者症状对侧黑质早期就存在FA值减低,DTI技术可作为早期帕金森病诊断的一项无创性检查方法,但对判断疾病的严重程度无帮助。

Purpose： To explore the diagnostic value of diffusion tensor imaging on early idiopathic Parkinson disease（IPD） with unilateral symptoms, and aim at providing clue for disease diagnosis and classification. Method： Twenty- six patients with early stage, untreated unilateral symptoms IPD and twenty controls were recruited in this study. UPDRS and Hoehn ＆ Yahr were evaluated before the MRI exam.All subjects were performed DTI on a 3.0 Tesla scanner, the fractional anisotropy（FA） value and apparent diffusion coefficient（ADC） value were obtained from the FA maps and ADC maps. Regions of interest（ROIs） were drawn on substantia nigra（SN）, putamen, the cephalosome of caudate nucleus and thalamus. Results： FA was reduced in the contralateral SN of symptoms of subjects with PD compared with the homolateral side and controls（ t = 2. 987, P = 0. 004; t = 3. 072, P = 0. 003）. There were no differences in others regions. There was no significant correlation between the FA of the contralateral SN of symptoms and the Unified Parkinson Disease Rating Scale. Conclusion： The FA value of the contralateral SN of symptoms in unilateral symptoms IPD patients was decreased in early stage, DTI could be served as a noninvasive diagnosis method for early stage PD. But it is not helpful to judge the severity of the disease.