扩散峰度成像对早期帕金森病患者黑质微观结构变化的研究

The Study of Diffusion Kurtosis Imaging on Microstructural Changes of Substantianigra in Patients with Early Parkinson’s Disease

目的:探讨扩散峰度成像(DKI)对早期帕金森病(PD)患者的脑黑质微观结构变化的诊断价值。方法:搜集30例早期PD患者作为PD组,20例健康志愿者作为对照组,均接受MRI常规序列及DKI检查,所有DKI扫描数据经后处理后,收集各定量参数图,三项参数分别是各向异性分数(FA)、平均扩散峰度(MK)及平均扩散率(MD),分别测量黑质的各项参数值,对各项参数值进行组间比较,分析其差异是否有统计学意义,并以受试者工作特征(ROC)曲线来评价DKI各参数值对早期PD患者的诊断效能。结果:PD组黑质FA值低于健康对照组;PD组黑质MD值与健康对照组无差异;PD组黑质MK值明显高于健康对照组。ROC曲线显示黑质FA值、MD值及MK值诊断早期PD的AUC分别为0.716、0.613和0.820,黑质MK值诊断早期PD患者具有一定准确性,诊断灵敏度、特异度高于FA值和MD值。结论:DKI可用于分析早期PD患者黑质微观结构的改变,其中MK值可以更好地反映早期PD患者黑质细微结构的变化信息。

Objective: To explore the diagnostic value of diffusion kurtosis imaging(DKI) the microstructure changes of substantianigra in patients with early Parkinson’s disease(PD). Methods: 30 patients with early PD were collected as the PD group while 20 healthy volunteers as the control group. All the subjects underwent brain routine magnetic resonance imaging(MRI) and DKI examination. The DKI scan data were processed to obtain quantitative parameter maps, with the three paramrters as fractional anisotropy(FA), mean diffusivity(MD) and mean kurtosis(MK). The DKI parameters of substantianigra(SN) were measured respectively and the differences between the two groups were statistically analyzed. The receiver operating characteristic(ROC) curve was used to evaluate the diagnostic efficacy of DKI parameters in patients with early PD. Results: The FA value of the substantianigra of the PD group was lower than that of the healthy control group, and the difference between the two groups was statistically significant. Compared with the healthy control group, the MD value of the substantianigra in the PD group was slightly higher, and the difference between the two groups was not statistically significant. The MK value of the substantianigra in the PD group was significantly higher than that in the healthy control group, and the difference between the two groups was statistically significant. The ROC curve showed the AUC of FA value, MD value and MK value in the substantianigra in the diagnosis of early PD were 0.716, 0.613 and 0.820, respectively. The substantianigra MK value showed certain accuracy in the diagnosis of early PD patients, and the diagnostic sensitivity and specificity were higher than the FA value and MD value. Conclusions:DKI can be used to analyze the changes of the microstructure of substantianigra in early PD patients, and the MK value can better reflect the changes of the microstructure of substantianigra in early PD patients.