早发性和晚发性帕金森患者磁共振差异比较

Differences in Magnetic Resonance Imaging Between Patients with Early Onset and Late Onset Parkinson’s Disease

目的探究早发性与晚发性帕金森患者在磁共振(MRI)影像检查上的差异。方法回顾性分析2016年2月至2019年2月在南阳医学高等专科学校第一附属医院接受检查与治疗的105例帕金森患者MRI检查资料,依据发病年龄将早发性(年龄≤50岁)和晚发性(年龄>50岁)帕金森患者分为早发组(n=52)和晚发组(n=53)。比较两组患者脑部感兴趣区平均磁化率、灰质密度及脑部灰质体积。结果晚发组患者脑部黑质网状部、壳核以及黑质致密部平均磁化率显著高于早发组患者(P<0.05);晚发组患者左海马旁回区、左额上回、左扣带回以及左额中回区域灰质密度显著低于早发组患者(P<0.05);早发组患者齿状核右侧与右侧灰质体积较晚发组患者显著降低(P<0.05),CrusⅡ右侧与左侧半球、Ⅶb与Ⅷa左侧半球、Ⅶb与Ⅷa右侧半球内侧和外侧灰质体积显著高于晚发组患者(P<0.05)。结论早发性和晚发性帕金森患者脑部铁沉积、脑部灰质密度以及体积存在差异,可为后期两者对症治疗提供依据。

Objective To investigate the differences in magnetic resonance imaging(MRI) between patients with ea rly onset and late onset Pa rkinson’s disease(PD).Methods A retrospective analysis was performed on MRI examinlation data of 105 PD patients who were examined and treated in the First Affiliated Hospital of Nanyang Medical College from February 2016 to February 2019.According to onset age,patients with ea rly onset(age not greater than 50 years old) or late onset(age greater than 50 years old) PD were divided into early onset group(n=52) and late onset group(n=53),respectively.The average susceptibility,gray matter density and brain gray matter volume in region of interest(ROI)were compa red between the two groups.Results The average susceptibility in brain substantia nigra reticular site,nucleus and substantia nigra compact part of late onset group was significantly higher than that in ea rly onset group(P<0.05).The gray matter density in left parahippocampal gyrus,left top frontal gyrus,left cingulate gyrus and left middle frontal gyrus of late onset group was significa ntly lower than that of early onset group(P<0.05).The gray matter volume at right odontoid nucleus in early onset group was significantly lower than that in late onset group(P<0.05),while gray matter volume at Crus Ⅱ right and left hemispheres,left hemispheres of Ⅶb and Ⅷa,medial and lateral right hemisphere of Ⅶb and Ⅷa was significantly higher than that in late onset group(P<0.05).Conclusion There are differences in brain iron deposition,brain gray matter density and volume in patients with early onset and late onset PD,which can provide basis for symptomatic treatment in late period.