帕金森病患者黑质酰胺质子转移磁共振成像研究——不同分期患者与正常对照者对比研究

Amide Proton Transfer MRI Signal of the Substantia Nigra in Parkinson's Disease-Comparison Study of Patients at Different Stages and Normal Controls

目的利用酰胺质子转移(APT)磁共振技术探讨不同分期帕金森病(PD)患者黑质APT信号的特征,并与正常对照者进行比较。方法对21名正常对照者(男12名,女9名,年龄56~75岁)和65例PD患者(男35例,女30例,年龄52~76岁)进行头部APT磁共振成像,测量双侧黑质的酰胺质子不对称磁化转移率(MTR_(asym))。将PD患者根据发病时间分为早期、中期和晚期(发病时间分别为≤1年、2~5年、≥6年),采用方差分析比较不同分期PD患者及正常对照者黑质MTR_(asym)(3.5 ppm)是否存在差异。结果 65例PD患者中,早期20例,中期22例,晚期23例,其黑质的MTR_(asym)(3.5ppm)分别为(1.17±0.15)%、(1.04±0.12)%及(0.88±0.17)%,均显著低于正常对照组(1.40±0.18)%(P值分别为0.038、0.001及<0.001)。结论磁共振APT成像信号有可能成为诊断PD患者的可靠分子标记物。

Objective To evaluate amide proton transfer（ APT） signal characteristics of the substantia nigra（ SN） in idiopathic Parkinson＇s disease（ PD） patients of different stages,comparing with normal controls. Methods APTw MR images of 21 normal controls（ 12 males,nine females,age 56- 75 years） and 65 idiopathic PD patients（ 35 males,30 females,age 52- 76 years） were acquired on a Philips 3 Tesla MRI system. Magnetization transfer spectra with 31 different frequency offsets（- 6 to 6 ppm） were acquired at the slice of the SN. MTRasym（ 3. 5 ppm） of the whole SN regions were measured. The PD patients were divided into three groups according to disease duration： early stage（ disease duration ≤ 1year）,mid stage（ disease duration 2- 5 years） and late stage（ disease duration ≥ 6 years）. One-way ANOVA was used to compare the APT MRI signal differences between normal controls and PD patients of different stages. Results Twenty early stage PD,22 mid stage PD and 23 late stage PD patients were included in this study. The measured MTRasym（ 3. 5ppm） values of the SN in PD patients showed decreased tendency with PD progression. Compared to that of normal controls,the MTRasym（ 3. 5 ppm） of PD patients significantly decreased,regardless of stage. Conclusion APT MRI signal of the SN is a potential imaging biomarker in diagnosing PD.