帕金森病脑内铁沉积的SWI定量研究

目的：通过比较帕金森病（PD）患者与正常对照组脑内多个结构的T2＊值，探讨PD的发病和进展与脑内铁沉积的关系。方法：采用3TMR系统对40例原发性PD患者及40例年龄、性别相匹配的健康志愿者（正常对照组）进行常规序列及SWI序列扫描。按Hoehn-Yahr分级量表将24例单侧症状PD患者作为PD-1组，16例双侧症状患者作为PD-2组。经后处理在T2＊图上分别手动测量双侧黑质致密带、黑质网状带、红核、苍白球、壳核、尾状核头、丘脑和额叶白质区共8个部位的T2＊值，并将所获得数据进行统计分析。结果：①PD-1组症状侧与正常对照组同侧在黑质致密部的T2＊值差异有统计学意义（P〈0．05），在其它7个部位的T2＊值差异无统计学意义（P〉0．05）；②PD-1组症状侧与正常对照组对侧在黑质致密部的T2＊值差异有高度统计学意义（P〈0．01），在黑质网状部的T2＊值差异有统计学意义（P〈0．05），在其它6个部位的T2＊值差异无统计学意义（P〉0．05）；③PD-1组症状对侧与正常对照组对侧在黑质致密部、红核的T2＊值差异有统计学意义（P〈0．05），而在其它部位的T2＊值差异无统计学意义（P〉0．05）；④PD-1组症状对侧与正常对照组同侧的各兴趣区T2＊值之间差异无统计学意义（P〉0．05）；⑤PD-1组和正常对照组各兴趣区的双侧T2＊值的差异均无统计学意义（P〉0．05）；⑥PD-2组与PD-1组和正常对照组间各兴趣区T2＊值差异均无统计学意义（P〉0．05）。结论：在PD的亚临床期脑内即有铁的异常沉积；局部铁含量的增加与单侧症状PD的发病有相关性，但与病情的严重程度无显著相关性；PD铁异常沉积的部位包括黑质致密部、黑质网状部、红核。

Susceptibility weighted imaging quantitative study of brain iron deposition in Parkinsonrs disease

Objective：To investigate the relationship between PD pathogenesis or progress and brain iron deposition in comparision with the difference of T2＊ values and in quantitative analysis of the variations of brain iron in several cerebral regions between Parkinson disease （PD） patients and control subjects. Methods：Forty patients with PD and 40 healthy con- trols,ranging in same ages and gender, underwent routine sequences and SWI sequence on a 3T MR scanner. Twenty-four PD patients with unilateral symptoms and 16 PD patients with bi-lateral symptoms were enrolled in PD-1 group and PD-2 group,respectivelv. T2＊ value was measured in both sides of substantia nigra pars compacta （SNc）, substantia nigra pars reticulata （SNr）, red nucleus （RN）, globus pallidus （GP）, putamen （PUT）, head of caudate nucleus （CN）, thalamus （THA） and frontal white matter （FWM） ,and statistic analysis was performed. Results：（1）The T2＊ values were significant- ly reduced in SNc of homolateral side of symptoms with PD-1 compared with the contralateral side （P〈0.05）. There was no differences in others regions （P〉0. 05） ;（2）The T2＊ values were significantly reduced in contralateral side SNc and SNr of symptoms of subjects with PD-1 compared with the homolateral side （P〈0. 05） ,and there was no significant difference in other regions （P〉0.05）;（3）There was a significant reduction in the T2＊ values in contralateral side SNc and RN of symptoms of subjects with PD-1 compared with the contralateral side （P〈0.05）. There were no differences in other re- gions （P〉0.05） ;（4）No significant difference was demonstrated in T2＊ values in all regions in homolateral side of symptoms of subjects with PD-1 compared with the contralateral side （P〉0.05） ;（5）There was no significant difference in the T2＊ values between the two sides in the PD-1 group （P〉0.05） ;（6）No significant difference was found in T2＊ values in all re- gions of interesting between PD-1 group and PD-2 group （P〉0.05）. Conclusion： In the subclinical period of PD there was already iron abnormal sedimentation in patient＇s brain. There is a relationship with the local iron content increase and unila- teral symptoms in the pathogenesis of PD, but there is no significant correlation with the severity of the illness. The parts of the iron abnormal deposition in PD includes compact part of substantia nigra, reticular part of substantia nigra, red nucleus.