ESWAN技术定量分析原发性不宁腿综合征患者的脑铁含量变化

ESWAN Technology Quantitative Analysis of Regional Brain Iron in Patients with Restless Legs Syndrome

目的探讨多回波采集T2WI三维梯度回波(ESWAN)技术在定量分析成人原发性不宁腿综合征(RLS)患者脑内灰质核团铁含量改变及其与国际不宁腿综合征研究组(IRLS)评分的相关性,评估其与RLS患者病情程度的敏感性与特异性。方法使用GE Signa Excite HD 3.0 T超导磁共振扫描仪对符合RLS临床诊断标准的35例患者和与35名相匹配的健康志愿者行ESWAN及常规扫描。应用GE Medical Systems Functool 4.4工作站软件进行图像后处理,并测得相应的幅度值和相位值。采用独立样本t检验比较RLS组和对照组实验数据,并与RLS组患者临床评分进行双变量相关分析(Pearson相关),采用受试者工作特征曲线(ROC)曲线下面积(AUC)对RLS患者病情程度敏感性比较。结果 (1)与对照组比较,RLS组的红核(P=0.004)、黑质致密部(P=0.002)、丘脑(P=0.027)差异具有统计学意义。(2)与临床评分的相关性分析:红核(r=0.836,P=0.000)、黑质致密部(r=0.763,P=0.000)、丘脑(r=0.797,P=0.000)的幅度log值与临床评分具有相关性,即与RLS的病情呈正相关。丘脑的相位值与临床评分具有正性相关(r=0.399,P=0.018)。(3)以丘脑的幅度log值绘制的AUC最大为0.949。结论 ESWAN技术能定量评价RLS患者脑内灰质核团铁含量变化、评估病情程度等,为临床诊疗提供更多信息。

Objective To investigate the clinical value of enhanced T2＊ weighted 3D gradient echo pulse（ ESWAN）sequence in evaluating brain iron content of gray nuclei in patients with idiopathic restless legs syndrome（ RLS）,and conduct bivariate correlation analyses with the International Restless Legs Study Group-IRLSSG scores in RLS patients group,and explore the Sensitivity and specificity of this method to assess the severity of the disease. Methods Thirty-five RLS Patients were selected as the study group,and 35 healthy volunteers who matched the patients in sex and age and Education level as the control group. Conventional MRI,ESWAN were performed in all patients and volunteers. All data were transferred to a GE ADW 4. 4 workstation for data Processing. Differences between the 2 subject groups were compared by using independent samples t test. The relationship between the brain iron content of gray nuclei values and IRLS scores,was studied using the Pearson correlation coefficient. Receiver Operating Characteristic（ ROC） curves was used to evaluate the sensitivity of this method to assess the severity of the disease. The results were analyzed. Results（1） Between the study group and the control group： the iron content differences in red nucleus（ RN）（ P = 0. 004）,substantianigra pars compacta（ SNc）（ P = 0. 002）,and thalamus was statistically significant（ TH）（ P = 0. 027）.（2） A. The log（ magnitude signal intensity） values of RN（ R = 0. 836,P = 0. 000）,SNc（ R = 0. 763,P = 0. 000）,TH（ R = 0. 797,P = 0. 000） in RLS group positively correlated with IRLS scores. B. The phase value of TH（ R = 0. 399,P = 0. 018） in RLS group positively correlated with IRLS scores.（ 3） The area under the ROC curve（ AUC） of the log（ magnitude signal intensity） values of thalamus best was 0. 949. Conclusion ESWAN technology can quantitativelyanalyzethe brain gray nuclei iron content in RLS patients.Therefore,this technique can provide valuable information for vivo diagnosis and evaluating the degree of RLS disease.