DTI在帕金森患者诊断中的应用
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摘要
目的探究弥散张量成像(DTI)在帕金森(PD)患者诊断中的应用价值。方法收集2013年1月-2017年12月我院就诊的62例PD患者的临床资料为PD组进行回顾性分析,另选取同期我院体检正常的62例健康志愿者为对照组,行常规头部MRI平扫及DTI检查,比较两组黑质、红核、苍白球、壳核、尾状核、丘脑、额叶白质各兴趣区的各向异性分数(FA值)及表观扩散系数(ADC值)。结果 PD组黑质、壳核的FA值显著低于对照组,差异有统计学意义(P﹤0.05),PD组红核、苍白球、尾状核、丘脑、额叶白质兴趣区的FA值与对照组比较,差异无统计学意义(P﹤0.05);PD组黑质、红核、苍白球、壳核、尾状核、丘脑、额叶白质各兴趣区ADC值与对照组比较,差异无统计学意义(P﹤0.05)。结论黑质、壳核的FA值有助于PD的诊断,DTI检查可为PD的病理机制及早期诊断提供有价值的客观依据。
Objective To explore the application values of diffusion tensor imaging(DTI) in the diagnosis of patients with Parkinson's disease(PD). Methods The clinical data of 62 PD patients(the PD group) treated in our hospital from January 2013 to December 2017 were retrospectively analyzed, and another 62 healthy volunteers with normal physical examination in our hospital during the same period were selected as the control group, and the two groups were given MRI plain scan and DTI check. The fractional anisotropy(FA values) and apparent diffusion coefficients(ADC values) of regions of interest such as substantia nigra, red nucleus, globus pallidus, putamen, caudate nucleus, thalamus and frontal white matter were compared between the two groups. Results The FA values of the substantia nigra and putamen in the PD group were significantly lower than those in the control group(P<0.05), and there was no significant difference in the FA values of regions of interest such as the red nucleus, globus pallidus, caudate nucleus, thalamus and frontal white matter between the PD group and the control group(P<0.05). There was no significant difference in the ADC values of substantia nigra, red nucleus, globus pallidus, putamen, caudate nucleus, thalamus and frontal white matter between the PD group and the control group(P<0.05). Conclusion The FA values of substantia nigra and putamen are helpful for the diagnosis of PD. DTI examination can provide a valuable objective basis for the pathological mechanism and early diagnosis of PD.
Objective To explore the application values of diffusion tensor imaging(DTI) in the diagnosis of patients with Parkinson's disease(PD). Methods The clinical data of 62 PD patients(the PD group) treated in our hospital from January 2013 to December 2017 were retrospectively analyzed, and another 62 healthy volunteers with normal physical examination in our hospital during the same period were selected as the control group, and the two groups were given MRI plain scan and DTI check. The fractional anisotropy(FA values) and apparent diffusion coefficients(ADC values) of regions of interest such as substantia nigra, red nucleus, globus pallidus, putamen, caudate nucleus, thalamus and frontal white matter were compared between the two groups. Results The FA values of the substantia nigra and putamen in the PD group were significantly lower than those in the control group(P<0.05), and there was no significant difference in the FA values of regions of interest such as the red nucleus, globus pallidus, caudate nucleus, thalamus and frontal white matter between the PD group and the control group(P<0.05). There was no significant difference in the ADC values of substantia nigra, red nucleus, globus pallidus, putamen, caudate nucleus, thalamus and frontal white matter between the PD group and the control group(P<0.05). Conclusion The FA values of substantia nigra and putamen are helpful for the diagnosis of PD. DTI examination can provide a valuable objective basis for the pathological mechanism and early diagnosis of PD.
引文
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[12]Kamagata K,Tomiyama H,Hatano T,et al.A preliminary diffusional kurtosis imaging study of Parkinson disease:comparison with conventional diffusion tensor imaging[J].Neuroradiology,2014,56(3):251-258.
[13]Zhang Y,Wu I W,Buckley S,et al.Diffusion tensor imaging of the nigrostriatal fibers in Parkinson's disease[J].Movement Disorders,2015,30(9):1229-1236.
[14]李梦婷,兰晓莉,唐军.PET用于帕金森病纹状体外小神经胶质细胞活化播散的研究[J].中华核医学与分子影像杂志,2017,21(3):192-192.
[15]杨涛,张春艳,程敬亮,等.磁共振弥散张量成像在早期帕金森病诊断中的应用研究[J].CT理论与应用研究,2017,26(1):85-90.
[2]王慧芳,田娟.MRI联合CT在诊断帕金森综合征中的应用价值分析[J].实用临床医药杂志,2017,21(21):81-82.
[3]Tir M,Delmaire C,Besson P,et al.The value of novel MRI techniques in Parkinson-plus syndromes:diffusion tensor imaging and anatomical connectivity studies[J].Revue Neurologique,2014,170(4):266.
[4]孙艳冬,齐晓飞,李春阳.帕金森病的影像学检查诊断进展[J].实用心脑肺血管病杂志,2014,22(7):8-11.
[5]陈燕生,刘兰祥,李彩英.帕金森病的MRI研究应用进展[J].放射学实践,2013,28(2):214-215.
[6]中华医学会神经病学分会帕金森病及运动障碍学组.中国帕金森病的诊断标准(2016版)[J].中华神经科杂志,2016,49(4):268-271.
[7]王蕾,熊中奎.磁共振成像在帕金森病诊断中的应用现状及研究进展[J].中国全科医学,2013,16(29):2771-2773.
[8]程永清,沙志涛,田有勇.帕金森病的影像学诊断[J].神经损伤与功能重建,2016,11(2):153-154.
[9]Langley J,Huddleston D E,Merritt M,et al.Diffusion tensor imaging of the substantia nigra in Parkinson's disease revisited[J].Human Brain Mapping,2016,37(7):2547-2556.
[10]苏军红,祁秀峰,申向辉,等.Nrf2-A R E通路在帕金森病大鼠黑质中的表达改变[J].中国医药导报,2014,11(35):8-11.
[11]李旺,牛朝诗.磁共振成像在帕金森病诊断中的研究进展[J].立体定向和功能性神经外科杂志,2017,30(3):180-184.
[12]Kamagata K,Tomiyama H,Hatano T,et al.A preliminary diffusional kurtosis imaging study of Parkinson disease:comparison with conventional diffusion tensor imaging[J].Neuroradiology,2014,56(3):251-258.
[13]Zhang Y,Wu I W,Buckley S,et al.Diffusion tensor imaging of the nigrostriatal fibers in Parkinson's disease[J].Movement Disorders,2015,30(9):1229-1236.
[14]李梦婷,兰晓莉,唐军.PET用于帕金森病纹状体外小神经胶质细胞活化播散的研究[J].中华核医学与分子影像杂志,2017,21(3):192-192.
[15]杨涛,张春艳,程敬亮,等.磁共振弥散张量成像在早期帕金森病诊断中的应用研究[J].CT理论与应用研究,2017,26(1):85-90.