Objective: Using magnetic resonance diffusion kurtosis imaging (DKI) to evaluate the microstructure changes of deep brain nucleus in Parkinson's disease (PD) as well as the correlation with clinical manifestations. Methods: Thirty-two PD patients were recruited into this study. Twenty gender and age matched healthy subjects served as the control group. All participants underwent MRI examinations, including T(1)WI, T(2)WI, DWI, susceptibility weighted imaging (SWI) and DKI. The original DKI imaging data were processed offline to calculate two parametric maps, including mean kurtosis (MK) value and fractional anisotropy (FA) value. Two DKI parameters measured from head of substantia nigra were compared between the two groups using t-test or Mann-Whitney U test according to data distribution. The correlations of the two DKI parameters in the substantia nigra of PD patients with the disease duration and clinical scales were tested by Spearmen or Pearson analysis according to data distribution. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of MK value in the substantia nigra for PD. Results: MK value in the substantia nigra of PD group (1.29±0.05) was significant higher than that of the control group (1.26±0.06) (t=2.24, P=0.03). There was no significant difference in FA value between the two groups. Spearmen correlation analysis revealed that there was no significant association of two DKI parameters in substantia nigra of PD patients with the disease duration and clinical scales. Conclusion: MR DKI of deep brain nucleuses can be useful for the diagnosis of PD, but it is not suitable to evaluate the degree of PD clinical symptoms.
目的: 利用磁共振扩散峰度成像技术(MR DKI)评价帕金森病(PD)患者脑深部核团的微结构改变,并分析其与临床表现的相关性。 方法: 收集苏州大学附属第二医院2014年9月至2016年4月经PD专科确诊的PD患者。同一时期内招募年龄、性别相匹配的健康对照者。所有受试者行常规颅脑MRI检查、磁敏感加权成像(SWI)及DKI。DKI原始图像数据经处理后,得到平均峰度(MK)和各向异性分数(FA)参数图,提取所有受试者两侧黑质的MK值和FA值,并比较其在两组间的统计学差异。分析PD组患者黑质MK值和FA值与病程及临床量表的相关性。以受试者工作特性(ROC)曲线评价黑质MK值对PD的诊断效能。 结果: 32例PD患者和20名健康对照者入组本研究。PD组黑质的MK值(1.29±0.05)较健康对照组(1.26±0.06)显著增高(t=2.24, P=0.03)。黑质FA值在两组间无显著差异。PD组黑质的MK值、FA值与病程、帕金森病统一评定量表第三部分(UDPRS-Ⅲ)评分、H-Y分级、简易精神状态检测量表(MMSE)评分及蒙特利尔认知量表(MoCA)评分均未发现显著的相关性。 结论: MR DKI技术对于PD的诊断具有一定的应用价值,但不适用于评估PD的临床症状。.
Keywords: Diffusion kurtosis imaging; Parkinson′s disease; Substantia nigra.