扩散峰度成像参数在帕金森病诊断中的价值研究

目的 利用扩散峰度成像技术评估帕金森病患者黑质微观结构改变情况,探讨扩散峰度成像参数在帕金森病诊断中的价值。 方法 收集温州医科大学附属台州医院2017年8月—2018年6月神经内科收治的45例帕金森病患者(PD组)和39例年龄、性别相匹配的健康对照者(HC组),均行颅脑结构磁共振成像(MRI)和扩散峰度成像(DKI)检查,对DKI数据进行后处理获得各向异性分数(fractional anisotropy,FA)、平均扩散率(mean diffusivity,MD)、轴向扩散率(axial diffusivity,AD)、径向扩散率(radial diffusivity,RD)、峰度各向异性分数(fractional anisotropy of kurtosis,FAk)、平均峰度(mean kurtosis,MK)、轴向峰度(axial kurtosis,AK)、径向峰度(radial kurtosis,RK)参数图,手工勾画双侧黑质作为感兴趣区(ROI),比较黑质各参数值在PD组和HC组之间的差异,用受试者工作特征(ROC)曲线评估有统计学差异的参数值的诊断效能。 结果 黑质FA值、FAk值、MK值、AK值在2组间差异有统计学意义(均P<0.05),PD组黑质FA值较HC组降低,而FAk值、MK值、AK值升高。黑质FA值、FAk值、MK值、AK值的ROC曲线下面积(AUC)分别为0.754、0.875、0.654、0.818。 结论 扩散峰度成像参数可用于帕金森病的诊断,黑质FAk值诊断效能最高。 

The value research of diffusion kurtosis imaging parameters in diagnosing Parkinson's disease

Objective Using diffusion kurtosis imaging(DKI) to assess the microstructure change of substantia nigra in Parkinson's disease patients so as to explore the value of diffusion kurtosis imaging parameters in diagnosing Parkinson's disease. Methods A total of 45 Parkinson's disease patients(PD group) and 39 healthy controls(HC group) with age and gender matched were recruited in August 2017 to June 2018 from Taizhou hospital affiliated to Wenzhou medical university, underwent structural MRI and DKI examination to all participants. Fractional anisotropy(FA), mean diffusivity(MD), axial diffusivity(AD), radial diffusivity(RD), fractional anisotropy of kurtosis(FAk), mean kurtosis(MK), axial kurtosis(AK) and radial kurtosis(RK) parametric images were obtained by postprocessing with DKI data. Manually drew the outline of substantia nigra as the region of interest(ROI), then statistically compared all the parameters of substantia nigra between PD group and HC group. By using receiver operating characteristic(ROC) curve to evaluate the diagnosis efficacy of parameters with statistically significant difference. Results FA, FAk, MK and AK value of substantia nigra had significant difference between the groups(all P<0.05). FA value of substantia nigra was lower in PD group, while FAk, MK and AK value of substantia nigra were higher in PD group. Area under curve(AUC) of ROC among FA, FAk, MK and AK value of substantia nigra were 0.754, 0.875, 0.654 and 0.818, respectively. Conclusion Diffusion kurtosis imaging parameters were valuable in diagnosing Parkinson's disease, FAk value of substantia nigra had the best diagnosis efficacy.