磁敏感加权成像(SWI)在帕金森病

磁敏感加权成像（SWI）在帕金森病的应用

【摘要】目的：磁敏感加权成像（SWI）在帕金森病诊断中的应用，分析其临床应用价值，为帕金森病的临床诊断手段提供一定的参考依据。方法：选取2015年1月到2016年1月期间本院经过全面检查确诊为帕金森病患者35例作为实验组研究对象，再选取同期来本院体检的非帕金森病健康人30例作为对照组研究对象，两组研究对象分别采取磁共振成像系统行常规的快速自旋回波T1、T2加权像后，进行尾状核头、苍白球、壳核、黑质以及红核等对比，同时观察不同级别帕金森病患者的尾状核头、苍白球、壳核、黑质以及红核等差异，分析磁敏感加权成像（SWI）在帕金森病诊断中的应用，为帕金森病的临床诊断手段提供一定的参考依据。结果：经过磁共振（SWI）系统常规快速自旋回波T1、T2加权像后，实验组帕金森病患者的壳核相位值的平均数和标准差（-0.1071±0.0512）与对照组的

（-0.0832±0.0327）相比差异具有统计学意义（P<0.05），实验组患者的黑质相位值的平均数和标准差（-0.1092±0.0503）与对照组的（-0.0835±0.0224）相比差异具统计学意义（P<0.05），实验组患者与对照组的尾状核头、苍白球以及红核相比差异没有统计学意义（P>0.05）。Ⅰ~Ⅱ级帕金森病患者、Ⅲ级帕金森病患者以及Ⅳ级帕金森病患者之间的苍白球、壳核以及黑质等相位值的平均数和标准差比较差异具有统计学意义（P<0.05），Ⅰ~Ⅱ级帕金森病患者、Ⅲ级帕金森病患者以及Ⅳ级帕金森病患者之间的尾状核头和红核之间比较差异没有统计学意义（P>0.05）。结论：帕金森病患者经过磁共振成像系统行常规的快速自旋回波T1、T2加权像后显示壳核和黑质与正常人相比明显降低，且帕金森病患者随着病情等级的升高苍白球、壳核以及黑质呈降低状态，表明磁敏感加权成像（SWI）在帕金森病中具有一定的应用价值。

【关键词】磁敏感加权成像（SWI）；帕金森病；灰质核团；应用研究

The application of susceptibility weighted imaging (SWI) in Parkinson's disease [Abstract] Objective:Application of magnetic susceptibility weighted imaging (SWI) in the diagnosis of Parkinson's disease, analysis of its clinical application value, to provide reference for the clinical diagnosis of Parkinson's disease. Methods: From January 2015 to January 2016, 35 cases of patients with Parkinson's disease were selected as the experimental group, and the results were confirmed as the experimental group,in the same period, 30 patients with non Parkinson's disease in our hospital were selected as the control group, two groups of subjects were taken magnetic resonance imaging system for T2 weighted fast spin echo T1, like conventional, was the head of caudate nucleus, putamen, globus pallidus and substantia nigra, red nucleus contrast, at the same time, observe the head of caudate nucleus, different levels of patients with Parkinson's disease globus pallidus, putamen, substantia nigra, red nucleus and other differences, analysis of magnetic susceptibility weighted imaging (SWI) in the diagnosis of Parkinson's disease, to provide reference for the clinical diagnosis of Parkinson's disease. Results: After the magnetic resonance (SWI) system, the conventional fast spin echo T1, T2 weighted image, the mean and

standard experimental group of patients with Parkinson disease putamen phase difference of the values (-0.1071 + 0.0512) and control group (-0.0832 + 0.0327) with statistical significance difference (P<0.05), in the experimental group, the mean and standard deviation (-0.1092 + 0.0503) of the substantia nigra phase were statistically significant (P<0.05) compared with the control group (-0.0835 + 0.0224), there was no significant difference between the experimental group and the control group in the caudate nucleus, the white ball and the red nucleus (P>0.05). I ~ II patients with Parkinson's disease, Parkinson's disease and grade IV patients with Parkinson disease between the globus pallidus putamen and substantia nigra phase values of the mean and standard deviation of the difference was statistically significant (P<0.05), there was no significant difference between the caudate nucleus and red nucleus in patients with Parkinson's disease, grade III Parkinson's disease and grade IV Parkinson's disease (P>0.05).Conclusion: Parkinson's disease patients after fast spin magnetic resonance imaging system for the conventional display putamen and substantia nigra decreased significantly compared with the normal T1, echo T2 weighted images, and Parkinson's disease patients with elevated level of globus pallidus putamen and substantia nigra decreased state, magnetic susceptibility weighted imaging (SWI) has a certain application value in Parkinson's disease.

[Key words] Susceptibility Weighted Imaging ( SWI) ; Parkinson's disease; Gray matter nuclei; Application research

帕金森这类疾病属于中老年人常见的运动障碍类疾病，以黑质多巴胺能神经元变性性缺失及黑质和蓝斑区路易小体形成为病理特征，其发病机制尚不清楚[1]。最近几年根据相关调查数据显示，帕金森病的发病率有显著上升趋势，给患者及家人的生活带来了严重影响。帕金森病患者的临床诊断主要通过患者的病史、临床症状体征等进行判断，缺少敏感性和特异性强的诊断手段[2-3]。帕金森病根据病理学检查证实患者脑内的苍白球、尾状核以及黑质铁的沉积增加，因此铁代谢异常已经是其发病机制中一个比较肯定的学说。根据国内外的相关文献研究发现铁是决定脑组织弛豫属性的重要物质，脑铁对弛豫的重要影响是缩短T2，并在一定程度上缩短T1。帕金森病患者铁的存在通过常规的MRI序列很难显示，磁敏感加权成像（SWI）可以反映帕金森病患者组织间的敏感性差异对比序列，且对帕金森病患者的非血红铁的显示更加清晰[4-5]。本院为了帕金森病临床诊断提供一定的参考依据，选取部分帕金森病患者作为研究对象与正常人群作对比，采用磁共振成像系统行常规的快速自旋回波T1、T2加权像，观察两组研究对象的尾状核头、苍白球、壳核、黑质以及红核等，同时比较不同级别帕金森病患者的尾状核头、苍白球、壳核、黑质以及红核等差异，现将研究结果总结报道如下：

1.资料与方法

1.1临床资料

选取2015年1月到2016年1月期间本院经过全面检查确诊为帕金森病患者35例作为实验组研究对象，再选取同期来本院体检的非帕金森病健康人30例作为对照组研究对象。