扩散峰度成像技术在帕金森患者黑质纹状体区的临床价值

目的探讨扩散峰度成像(DKI)技术在特发性帕金森患者黑质纹状体区的临床价值，分析其与临床进展的相关性。方法选取我院经临床确诊为帕金森病的患者35例为观察组，收集同期我院就诊的健康对照人群20例为对照组，所有受试者均在3.0 T磁共振成像机上进行MRI常规扫描、DKI序列扫描，在后处理的DKI序列上分别测量双侧黑质(SN)区的平均弥散分度值、各向异性分数值、轴向峰度值、径向峰度值。比较两组平均弥散分度、各向异性分数、轴向峰度、径向峰度均值，寻找各脑区存在差异的影像学指标。将观察组患者分为帕金森早期组(n=13)及进展期组(n=22)，寻找DKI中平均弥散分度、各向异性分数值与临床病程进展有无相关性。结果观察组双侧黑质平均弥散分度均数值较对照组明显增高，差异具有统计学意义(P < 0.05)；各向异性分数值较对照组减小，差异具有统计学意义(P < 0.05)；轴向峰度、径向峰度值差异无统计学意义(P>0.05)。早期帕金森组和进展期帕金森组双侧黑质平均弥散分度及各向异性分数值与临床病程、分级均未发现显著相关性(P>0.05)。结论DKI参数中平均弥散分度值及各向异性分数值可以成为神经退化过程的早期生物标志物。DKI中平均弥散分度、各向异性分数值暂不适用评估帕金森患者病情进展程度。

Clinical value of magnetic resonance DKI technique in the nigrostriatal region of Parkinson's disease patients and its correlation with clinical progress

ObjectiveTo explore the clinical value of Diffusion Kurtosis Imaging (DKI) in nigrostriatal region of idiopathic Parkinson's disease and analyze the correlation with clinical progress.MethodsThirty-five patients diagnosed of Parkinson's disease in Xinjiang Second Clinical Hospital were selected as the case group, and 20 healthy control patients in our hospital during the same period were collected as the control group. All subjects underwent MRI routine scanning and DKI sequence scanning on a 3.0 T magnetic resonance imaging machine. The mean Kurt Osis (MK) values of bilateral substantia nigra were measured on the postprocessed DKI sequence respectively. The average values of MK, Anisotropic fraction (FA), axial kurtosis (AK) and radial kurtosis (RK) in the brain of the case group and the control group between 2 groups were compared. Patients in the case group were divided into early Parkinson's disease group (n=13) and advanced Parkinson's disease group (n=22).ResultsThe mean values of MK in the bilateral substantia nigra of the case group were significantly higher than those of the control group (P < 0.05), while the FA values were lower than those of the control group (P < 0.05). The AK and RK values between 2 groups had no significant difference (P>0.05). No significant correlation was found between MK and FA values of bilateral substantia nigra in early PD group and advanced PD group (P>0.05).ConclusionMK and FA values in DKI parameters can be used as early biomarkers of neurodegeneration. MK and FA values in DKI are not suitable for evaluating the progress of PD patients.