磁敏感加权成像序列下黑质小体-1信号强度值与帕金森病的临床相关性探讨

Clinical correlation between substantia nigra-1 signal intensity under SWI sequence and Parkinson′s disease

目的通过磁敏感加权成像(SWI)序列分析“燕尾征”(黑质小体-1)各感兴趣区信号强度值,探讨其对帕金森病(PD)的诊断价值及与病程、分期的相关性。方法回顾性分析37例确诊PD患者(PD组,包括22例早期患者及15例中晚期患者)及34例年龄、性别匹配的健康对照组行SWI检查,由2名医师评判受试者黑质小体-1的显示状态(清晰、模糊或消失);测量、比较2组黑质小体-1区整体、前、中、后感兴趣区的信号强度值,并分析PD组相关参数与病程及分期之间的关系。结果22例早期PD患者中7例双侧黑质小体-1区尚存短线、短棒或点状结构,13例显示“燕尾征”结构一侧较对侧降低或消失,2例早期PD及15例中晚期PD患者显示双侧“燕尾征”结构模糊甚至完全消失;其中单侧形态异常与临床早期单侧起病患者匹配。PD组较对照组各感兴趣区信号强度值明显降低(P<0.05);早期PD组与中晚期组PD患者差异无统计学意义(P>0.05);PD各组信号强度值与病程及分期无明显相关性。结论SWI图像上黑质小体-1区信号强度值与其形态变化及PD患者的临床诊断密切相关,对其准确诊断可能有重要指导意义。

Objective To explore its diagnostic value for Parkinson′s disease(PD)and its relationship with the course and stage relevance by analyzing the signal intensity of each region of interest of the"swallowtail sign"(substantia nigra-1)through magnetic sensitivity weighted imaging(SWI).Methods SWI was performed retrospectively in 37 patients diagnosed with PD(PD group,including 22 patients in the early stage and 15 patients in the advanced stage)and 34 healthy controls matched by age and sex,and display status of the substantia nigra corpuscle-1(clear,fuzzy or disappearing)of the subjects were evaluated by two physicians.The signal intensity values of the entire,anterior,middle,and posterior regions of interest of the substantia nigra corpuscle-1 in the two groups were measured and compared,and the relationship between parameters in PD group and disease course and stage were analyzed.Results Among the 22 patients with early PD,there were 7 cases showed short lines,short rods or dots in the bilateral substantia nigra corpus 1 area,and 13 cases showed the"dovetail sign"structure decreased or disappeared on one side compared to the contralateral side.There were 2 cases with early-stage PD and 15 patients with intermediate-advanced PD showed a fuzzy or even disappeared bilateral"swallowtail sign"structure.The unilateral morphological abnormality matched the early clinical unilateral onset patients.Compared with the control group,the signal intensity of each area of interest in the PD group was significantly lower(P<0.05).There was no significant difference between the early PD group and the middle and late PD patients(P>0.05),and there was no significant correlation between the signal intensity and the course and stage of PD.Conclusion The signal intensity value of substantia nigra corpus-1 region in SWI images is closely related to its morphological changes and clinical diagnosis of PD patients,which may have important guiding significance for its accurate diagnosis.