磁共振弥散张量及磁敏感加权成像对早期原发性单侧症状帕金森病的诊断价值

Diagnostic value of diffusion tensor imaging and susceptibility weighted imaging in early unilateral unilateral Parkinson's disease

目的探讨磁共振弥散张量(DTI)及磁敏感加权成像(SWI)诊断早期原发性单侧症状帕金森病(PD)的价值。方法纳入河南省人民医院2015-10—2017-11收治的早期原发性单侧症状PD患者40例,将其作为PD组,选取同期于体检的40例健康体检者为对照组。2组均接受磁共振DTI及SWI检查,比较PD组症状同侧、对侧以及对照组双侧感兴趣区的表观弥散系数(ADC值)、各向异性分数(FA值)、校正相位值(CP值),采用ROC曲线模型分析感兴趣区相关参数对早期原发性单侧症状PD的预测价值。结果 PD组症状同侧、症状对侧壳核、黑质、丘脑、苍白球、红核的ADC值与对照组比较差异均无统计学意义(P>0.05)。PD组症状对侧的黑质FA值低于PD症状同侧与对照组,差异有统计学意义(P<0.05)。PD组症状对侧黑质CP值低于PD症状同侧与对照组,差异有统计学意义(P<0.05)。结论在DTI及SWI检测的各参数中,黑质FA值、CP值对早期原发性单侧症状PD的诊断价值较高,可作为临床重点诊断指标。

Objective To investigatethe value of magnetic resonance diffusion tensorimaging （DTI） and magnetic sensitive weighted imaging （SWI） in the early diagnosis of primary unilateral symptomatic Parkinson＇s disease （PD）. Methods We recruited 40early primary unilateral symptom PD patients as PD group in our hospitalfrom October 2015 to November 2017.40 healthy persons who were examined in our hospital during the same period were selected as control group.The two groups were examined by magnetic resonance DTI and SWI.The apparent diffusion coefficient （ADC value）,anisotropic fraction （FA value） and corrected phase value （CP value） of the bilateral areas of interest in the PD group were compared with those in the ipsilateral,contralateral and control groups.ROC curve model was used to analyze the predictive value of relative parameters of the areas of interest for early primary unilateral symptom PD. Results There were no statistically significant differences in the ADC value between putamen,substantia nigra,thalamus,globus pallidus and red nucleus of the ipsilateral symptoms and contralateral symptoms in group PD and those of the control group （ P 〉0.05）.The FA value of the contralateral substantia nigra in group PDwas lower than that of the symptomatic ipsilateraland the control group.There were statistically significant differences （ P 〈0.05）.The CP value of contralateral substantia nigra in group PD was lower than that of symptomatic ipsilateral and control group.There were statistically significant differences （ P 〈0.05）. Conclusion Among the parameters detected by DTI and SWI,the FA value and CP value of substantia nigra are the higher diagnostic value for early primary unilateral symptom PD,and can be used as the key clinical diagnostic criteria.