帕金森氏病精神障碍的磁共振弥散张量研究

目的：应用3.0T磁共振成像仪、磁共振弥散张量成像技术对帕金森氏病精神障碍（PDPsy）、无精神病性症状PD患者及正常对照组感兴趣区的神经纤维束进行定量分析，探讨各感兴趣区FA值的变化与PDPsy的关系及PDPsy可能的发病机制．方法选取16名PDPsy患者（PDPsy组），性别、年龄及病程相匹配的无精神病性症状的24名PD患者（PD组）以及同期年龄、性别相匹配的健康体检者20名（正常对照组），进行常规MR头部平扫和DTI检查，重建FA图，对双侧黑质-纹状体纤维环路穿越的部位（黑质、红核、丘脑、苍白球）以及与精神分裂症相关的额、枕叶、扣带回的FA值进行统计分析．结果 PDPsy组与PD组黑质的FA值低于正常对照组（P＜0.05）；PDPsy组额叶、枕叶FA值显著低于正常对照组（P＜0.05）；PDPsy组额叶、枕叶、扣带回FA值低于PD组，但两者间差异无统计学意义（P＞0.05），PD组额叶、枕叶FA值低于正常对照组，但两者间差异无统计学意义（P＞0.05）．结论 DTI能无创性定量测量PDPsy患者各脑区的FA值，在分子影像学水平揭示PDPsy相应神经环路的改变，可为PDPsy的病理机制和临床表现提供较多信息．

Study of Psychosis Associated with Parkinson Disease by Diffusion Tensor Imaging

Objective Using 3.0T magnetic resonance imaging and diffusion tensor magnetic resonance imaging, quantitative analysis of nerve fibers in region of interest was conducted in patients with psychosis associated with parkinson disease （PDPsy）, PD patients without psychotic symptoms and normal control group, then investigate the relationship between FA value change in the region of interest and PDPsy, and the pathogenesis of PDPsy. Methods Sixteen patients with PDPsy, 24 PD patients without psychotic symptoms and 20 healthy persons with the corresponding age and sex （normal control group） were enrolled in this study. The patients with PDPsy and patients without psychotic symptoms have the matched gender, age and disease duration. All patients were underwent routine MR plain scan and DTI scan. The FA graph was reestablished, and the FA values of the bilateral substantia nigra-striatum fiber loop through the site （substantia nigra, red nucleus, nucleus, globus pallidus）, frontal, occipital lobe and cingulate associated with schizophrenia were statistical analyzed. Results The nigral FA values in PDPsy and PD groups were significantly lower than that in control group. The frontal lobe and occipital lobe FA values in PDPsy group were significantly lower than those in control group. The frontal lobe, occipital lobe and cingulate FA values in PDPsy group were lower than those in PD group, but there were no significant differences between the two groups. The frontal lobe and occipital lobe FA values in PD group were lower＆amp;nbsp;than those in the control group, but there were no significant differences between the two groups. Conclusion DTI is a noninvasive and quantitative measurement for FA values of various brain regions in patients with PDPsy. It can reveal the PDPsy corresponding neural loop changes at the molecular imaging level, and can provide more information for the pathogenesis and clinical manifestations of PDPsy.