颅脑MRI在帕金森病与帕金森综合征的鉴别价值分析

目的探讨颅脑磁共振成像在帕金森病(Parkinson's disease,PD)与血管性帕金森综合征(vascular Parkinson syndrome,VP)鉴别诊断中的价值。方法选取42例确诊PD和46例确诊VP患者为受试对象,分别纳入PD组和VP组;将同期入院体检的50例健康志愿者纳入对照组。所有受试者均接受颅脑MRI检查。记录三组患者黑质致密带(substantia nigra zona compacta,SNc)宽度(width of pars compacta of substantia nigra,WPCSN)值、中脑直径及两者比值检测结果差异,分析PD患者及VP患者颅脑MRI影像特征。结果三组受试者中脑直径对比差异无统计学意义(P0.05);PD组WPCSN值及WPCSN值/中脑直径检测结果均显著低于VP组和对照组(P0.05);VP组和对照组上述两项指标检测结果对比差异无统计学意义(P0.05)。PD组颅脑MRI影像示无特殊改变或颅脑正常老化改变者居多,VP组颅脑MRI影像多示颅内缺血性改变异常信号,主要区域为皮质下、侧脑室旁脑白质及基底节区等,小脑及脑干累及病例较少。结论颅脑MRI可在PD和VP鉴别诊断中发挥积极作用,具有较高的应用价值。

Value of Brain MRI in Differential Diagnosis of Parkinson's Disease and Parkinson Syndrome

Objective To investigate the value of brain magnetic resonance imaging in differential diagnosis of Parkinson's disease (PD) and vascular Parkinson syndrome (VP). Methods Fourty-two patients with confirmed PD and 46 patients with confirmed VP were selected as subjects and were included in PD group and VP group respectively, 50 healthy volunteers who underwent physical examination in the hospital during the same period were included in the control group. All subjects underwent brain MRI examination. The differences in detection results of substantia nigra zona compacta (SNc) width of pars compacta of substantia nigra (WPCSN) value, diameter of midbrain and ratio of the two among the three groups were recorded. The brain MRI characteristics of patients with PD and patients with VP were analyzed.Results The differences in diameter of midbrain among the three groups were not statistically significant (P>0.05). The detection results of WPCSN value and WPCSN/ diameter of midbrain in PD group were significantly lower than those in VP group and those in the control group (P<0.05). There was no significant difference in the detection results of indexes mentioned above between VP group and the control group (P>0.05). Brain MRI of PD showed no special changes or mainly showed normal aging of brain. Brain MRI of VP group mainly showed intracranial ischemic change with abnormal signal and the main areas were subcortical, periventricular brain white matter and basal ganglia, etc. Cases with cerebellum and brainstem involvement were few.Conclusion Brain MRI can play an active role in the differential diagnosis of PD and VP, which is of high application value.