DTI观察帕金森病患者黑质纹状体改变应用研究

Application study of nigrostriatal system in Parkinson disease patients by diffusion tensor imaging

目的:采用DTI研究帕金森病(Parkinson disease,PD)患者与对照组多个脑区各向异性分数(FA值)的差异。方法:收集2010年6月至2013年5月37例PD,其中男24例,女13例;随机选取22例健康志愿者作为对照组。PD患者采用Hoehn-Yahr分级,分为Ⅰ和Ⅱ级20例,Ⅲ和Ⅳ级17例;均行常规MRI扫描及DTI序列扫描,在所得FA图像上测量黑质纹状体各核团(双侧尾状核头、壳核、黑质)的FA值,确定各组有差异的FA值脑区。结果:PD组与对照组双侧尾状核头、壳核、黑质FA值差异有统计学意义(P<0.05);其中早期PD患者黑质FA值与中晚期PD组差异有统计学意义(P<0.05);早期PD患者尾状核头、壳核FA值与中晚期PD组差异无统计学意义(P>0.05)。结论:DTI技术作为一种无创研究PD患者黑质纹状体生理改变的方法,提示黑质纹状体部位的FA值改变可能是诊断PD的线索。

Objective： To investigate the change of fractional anisotropy （FA） value in brain of Parkinson disease （PD） patients noninvasively by using DTI. To provide a noninvasive and valuable biological indicator for diagnosis. Methods： There were 37 patients with primary PD （24 men,13 women） aged 65.1±12.4 years,which had a disease duration of 0.5-14 years,and 22 age-matched volunteers （11 men and 11 women） as control group,the mean age were 61.3±13.5 years. There was no significant difference between the two groups in age. Conventional T1WI, T2 WI, DTI images were examined. The fractional anisotropy value of the bilateral brains of caudate nucleus （CAU）, putamen （PUT）,substantia nigra （SNr） were evaluated in FA image. Results： The FA value of bilateral CAU, SNr and PUT in PD group were significantly lower than that in control group （P〈0.05）. The FA values of bilateral SNr were significantly different between early PD group and advanced PD group （P〈0.05）. Conclusion： DTI provides a non-invasive method for studying the process of pathological changes of FA value in PD and it can help us to recognize and detect PD. This study suggests that the FA value of nigrostriatal system might be a reliable clue in diagnosis of PD.