磁敏感加权成像在测量帕金森病黑质铁沉积面积中的初步应用

Susceptibility-weighted imaging in detecting the iron accumulation area in the substantia nigra of patients with Parkinson＇ s Disease

目的探讨磁共振磁敏感加权成像（SWI）在PD患者脑铁沉积面积测量中的初步应用价值。方法收集自2008年2月至2009年12月间福建医科大学附属协和医院行头颅MR检查的原发性PD患者30例，设为患者组，另设同期健康体检及正常志愿者19例为对照组。对2组成员行头颅SWI序列扫描。其中患者组成员再根据Hoehn－Yahr分级分为I～Ⅱ级组（19例），Ⅲ～Ⅳ级组（11例）；根据病程分为≤5年组（8例）及〉5年组（22例），分别测量不同级别及病程的2组患者黑质铁沉积面积。结果患者组与对照组成员黑质铁沉积面积分别为（380．6±63．6）pixel和（507．6±97．6）pixel，差异有统计学意义（P〈0．05）。I～Ⅱ级与Ⅲ～Ⅳ级PD患者、≤5年和〉5年PD患者之间黑质面积差异无统计学意义（P〉0．05）。结论SWI对铁沉积非常敏感，可以通过测量黑质铁沉积面积客观评价PD患者脑铁沉积情况。

Objective To evaluate the primary clinical value of susceptibility-weighted imaging （SWI） in the area measurement of brain iron accumulation in patients with Parkinson＇s disease （PD）. Methods A total of 30 patients with PD, admitted to our hospital from February 2008 to December 2009, and 19 age-matched normal controls were employed in our study; they accepted the brain MR examinations with conventional and SWI sequences. PD patients were classified into 2 sub-groups according to Hoehn-Yahr grading： patients of I-II stage （n=19） and patients of III-IV stage （n=11）. PD patients were also divided into 2 sub-groups according to disease durations： patients with duration of ≤ 5 years （n=8） and patients with duration of 〉5 years （n=8）. Regions of interest （ROI） of substantia nigra （SN） were handed-drawn on phase images. Two-sample t- test was used for comparison between patients groups and normal controls. Results The iron deposition area of SN in PD patient group （[380.6± 63.6] pixel） was significantly different as compared with that in normal controls （[507.6±97.6] pixel, P〈 0.05）; however, that between patients of MI stage and patients of III-IV stage was not significantly different （P〉0.05）, neither was between patients with different disease durations （P〉0.05）. Conclusion SWI is a non-invasive sensitive quantitatively method in studying the iron deposition in PD patients by detecting the iron deposition area.