磁敏感加权成像定量测量在鉴别诊断帕金森病和血管性帕金森综合征中的应用

Application of Quantitative Measurement in Differential Diagnosis of Parkinson's Disease and Vascular Parkinsonism by Susceptibility-weighted Imaging

目的探讨在磁敏感加权成像(SWI)上测量脑内锥体外系各核团相位值对帕金森病(PD)和血管性帕金森综合征(VPS)的诊断及鉴别诊断价值。资料与方法在SWI上对20例PD患者(PD组)、20例VPS患者(VPS组)和20例正常对照者(对照组)脑内锥体外系各核团进行相位值测量,并进行比较。结果 PD组较VPS组及对照组黑质致密带(SNc)、苍白球(GP)、壳核(PUT)相位值均明显降低(P<0.01);VPS患者与对照组比较,差异无统计学意义(P>0.05)。PD组SNc、GP及PUT相位值在早期即已经降低,随病情加重其相位值进一步降低(P<0.01);中晚期其黑质网状带(SNr)相位值降低(P<0.05)。VPS组在早中期各感兴趣区相位值均无明显变化,仅在晚期SNc、PUT、尾状核(CN)及SNr、GP相位值轻度降低(SNc、PUT、CN:P<0.01;SNr、GP:P<0.05)。双侧红核(RN)比较,差异均无统计学意义(P>0.05)。结论应用SWI测量脑内锥体外系各核团相位值对PD和VPS的评估具有临床诊断价值。

Purpose To evaluate the value of phase value of nuclei in extracorticospinal tract measured on susceptibility-weighted imaging （SWI） in differential diagnosis of Parkinson＇s disease （PD） and vascular parkinsonism （VPS）. Materials and Methods The phase value of nuclei in extracorticospinal tract were measured and compared in 20 patients with PD, 20 patients with VPS and 20 healthy control subjects on susceptibility-weighted imaging （SWI）. Results The phase values of sustantia nigra pars compacta （SNc）, globus pallidus （GP） and putamen （PUT） in PD group significantly reduced compared with those in VPS group and control group （P 0.01）. The phase value of SNc, GP and PUT reduced at the early stage in PD group, and then further reduced with the severity of disease; the phase value of sustantia nigra pars reticulata （SNr） reduced at the medium to late stage （P 0.05）. The phase value of SNc, PUT, caudate nucleus （CN）, SNr and GP did not reduce at the early to medium stage in VPS group, and slightly reduced at the late stage （P 0.01, P 0.05）, but no statistical difference in phase value of bilateral red nucleus was observed （P 0.05）. Conclusion Measurement of phase value of nuclei of extracorticospinal tract on SWI is reliable to diagnose PD and differentiate PD from VPS.