摘要
目的探讨磁共振弥散张量成像(diffusion tensor imaging,DTI)技术在帕金森病(Parkinson’s disease,PD)诊断中的临床应用价值。方法筛查入组帕金森研究组27例,其中震颤型12例,强直型15例,筛查对照组22例,均排除抑郁、焦虑及痴呆。分别对研究组与对照组、强直型组与对照组、震颤型组与对照组及强直型组与震颤型组进行感兴趣区DTI对比,感兴趣区为内侧苍白球、外侧苍白球、壳核、尾状核、丘脑底核、黑质、红核、小脑上脚、小脑中脚、小脑蚓部、小脑齿状核、小脑扁桃体。结果与对照组比较,研究组病灶侧壳核、尾状核、黑质、小脑扁桃体、小脑齿状核FA较对照组低,ADC升高。与对照组比较,强直型组尾状核FA值下降。与对照组比较,震颤型组壳核及小脑齿状核FA值下降,ADC值升高。与震颤型组比较,强直组小脑上脚FA值高。结论 DTI技术对PD诊断具有一定临床价值。壳核、尾状核、黑质参与传统STC通路(纹状体-丘脑-皮层通路),小脑齿状核参与了CTC通路(小脑-丘脑-皮质通路),尤其在震颤型患者中作用更大,尾状核在强直型患者中作用突出。
Objective To explore the clinical value of diffusion tensor magnetic resonance imaging (DTI) in the diagnosis of Parkinson’s Disease. Methods 27 PD patients were recruited in our study, including 12 patients confirmed as tremor type and 15 confirmed as rigidity type. 22 healthy participants were included in the control group. Participants with depression, anxityor dementia were excluded. The ADC value and FA of regions of interests (ROI) from all participants were collected. The ROI included globus pallidus intermal, globus pallidus external, putamen, caudate nucleus, subthalamic nuclei, substantia nigra, red nucleus, superior cerebellar peduncle, vermis, dentate nucleu, and cerebellar tonsil. Results Compared with the control group, PD patients showed significant decreases in the value of FA and significant increases in the value of ADC in putamen, caudate nucleus, substantia nigra, dentate nucleu and cerebellar tonsil. The FA of caudate nucleus was significantly lower in patients of rigidity type than that in the healthy control group. The FA of the putamen and dentate nucleu were significantly lower in patients of tremor type than that in the control group, while the ADC were significantly increased. PD patients of rigidity type showed significant increases in the value of FA in the superior cerebellar peduncle compared with patients of tremor type. Conclusion the DTI may contribute to the diagnosis of PD. Putamen, dentate nucleu and substantia nigra was involved in STC pathway, while Dentate nucleu was involved in CTC pathway.
作者
余健敏
李蒙燕
周进
张惠丽
YU Jianmin;LI Mengyan;ZHOU Jin;ZHANG Huili(Guangzhou First People`s Hospital, Guangzhou 510180, China)
出处
《现代医院》
2019年第4期600-604,共5页
Modern Hospitals
基金
广州市医药卫生科技项目(编号:20161A011002)
关键词
帕金森病
磁共振
弥散张量
Parkinson’s Disease
Magnetic Resonance
Diffusion Tensor Imaging
