SWI测量脑铁沉积在帕金森病中的临床应用价值

The application of measurement of the brain iron deposition in patients with Parkinson's disease on susceptibility weighted imaging

目的拟通过磁敏感加权成像技术(SWI)评估帕金森病(PD)脑铁变化在校正相位图上造成的相位值的改变,探讨磁共振成像(MRI)对PD脑铁病理性改变的诊断价值。方法前瞻性收集原发性PD患者33例(PD组),另选健康自愿者22例为对照组(NC组)。所有PD患者采用Hoehn-Yahr分期,其中Hoehn-Yahr分期≤2.5期18例、>2.5期15例,行SWI序列扫描,在所得相位图上测量各脑区(双侧尾状核头、壳核、丘脑、黑质、红核、齿状核、苍白球)的相位位移值,利用公式f(x)=-x.π/4 096计算出各脑区的相位值。因相位值与脑铁沉积呈反比,分析相位值的差异可以半定量分析脑铁含量的分布。结果 PD组与NC组双侧尾状核头、苍白球、黑质相位值比较,差异有统计学意义(P<0.05),双侧壳核、丘脑、齿状核及红核相位值比较,差异无统计学意义。结论 SWI对显示脑内铁沉积非常敏感,可以通过测量相关脑区信号强度并计算出相位值以评价脑铁沉积,为活体研究PD脑铁含量提供了相对简单、无创的方法。

Objective To investigate the change of iron deposition in the brain of PD patients noninvasively by using SWI phase value and to provide a noninvasive and valuable biological indicator for the diagnosis of PD. Methods All patients were recruited from the in-patient and out-patient of the Anqing Petrol Hospital,which were diagnosed as primary Parkinson＇s disease during June 2010 and May 2012. There were 33 patients with PD（22 men, 11 women） aged 62. 1 ± 14. 2, who had a mean disease duration of 4.8 ± 3.7 years, and 22 age-matched volunteers （ 11 men and 11 women） as control group,the mean age were 62.2 ± 12. 4. There were no significant difference between the two groups in age. The SWI images were examined. The phase-shifted value of the bilateral head of caudate nucleus （ CAU）, putamen （ PUT）, thalamus （ TH ）, substantia nigra （ SNr）, red nucleus （ RN ）, dentate mucleus （ DN ） and globus pallidus（GP） were evaluated in the corrected phase image. Phase values were obtained from the formula as follows： f（x） =-x . π/4 096. Statistical analysis was performed by using SPSS for Window（ version 19.0）. Resuits The phase value of bilateral CAU, SNr and PUT in PD group were significantly lower than that in the control group （P 〈 0.05 ）. The phase value of bilateral RN, TH, DN and PUT had no significant difference between the two groups （ P 〉 0. 05 ）. Conclusion SWI provides a non-invasive method for study of the process of pathological changes of iron deposition and diagnosis in PD.