摘要
目的:应用基于DTI的白质图分析(DTI-ABA)方法,探讨MSA-p及PD患者胼胝体解剖连接隐匿损伤及DTI在MSA-p及PD辅助鉴别诊断中的价值。方法:选择PD患者18例,MSA-P患者18例,性别、年龄相匹配的健康对照(HC)20例行DTI扫描,应用DTI-ABA方法获得胼胝体各部分的DTI参数值,其参数包括FA、MD、RD、AD,进行3组数据比较分析,并行DTI参数与UPDRS-Ⅲ相关性分析。结果:与HC及MSA-p组比较,PD组胼胝体体部、压部、左毯部FA值降低(P<0.05);膝部、体部、压部的MD值、AD值和RD值升高(P<0.05)。MSA-p与HC相比胼胝体各部各DTI参数均无改变。PD组胼胝体膝部、体部及压部的FA值与UPDRS-Ⅲ得分负相关,体部、压部及双侧毯部的RD值与UPDRS-Ⅲ得分呈正相关。胼胝体体部的MD值、RD值诊断PD的敏感度、特异度分别为83.3%、94.7%以及77.8%、88.6%。结论:PD患者胼胝体存在隐匿性损伤,而在MSA-p患者未发现这种现象,DTI可在一定程度上可帮助MSA-p及PD的鉴别诊断。
Objective： To investigate the occult injury of anatomical connectivity of the corpus eallosum in patients with Parkinson variant of multiple system atrophy （MSA-p） and patients with Parkinson disease （PD） ,and to explore the value of diffusion tensor imaging （DTI） in auxiliary differential diagnosis of MSA-p and PD using DTI Atlas-based analysis （ABA）. Methods： 18 patients with PD, 18 patients with MSA-p and 20 healthy controls （HC） whose gender and age matched those of the patients were recruited to receive DTI scanning. The DTI parameters such as FA, MD, RD and AD values in corpus callosum,including genu,body, splenium, and bilateral tapetum were analyzed by DTI-ABA. The difference of each DT1 parameter among the three groups was compared and the correlation between DTI parameters and UPDRS-III scores was analyzed in the PD and MSA-p group. Results： In comparison with HC and MSA-p, reduced FA value in the body,splenium and left tapetum of the corpus callosum,and increased MD,AD and RD values in the genu,body and splenium of the corpus callosum were found in PD, respectively （P^0.05）. There were no changes of DTI parameters of each part of corpus callosum between MSA-p and HC. In PD group, FA in genu, body and splenium of the corpus callosum showed negative correlation with UPDRS-III scores. While RD values in body,splenium and bilateral tapetum of the corpus callosum presented positive correlation with UPDRS-III scores. The MD and RD in the body of the corpus callosum had higher diagnostic efficiency of PD, with their sensitivity and specificity value of 83.3 %,94.7 % fro and 77.8 %, 88.6%, respectively. Conclusion：The occult injury of corpus callosum can be found in PD patients rather than in MSA-p patients. To a cer- tain extent,the DTI analysis might contribute to the differential diagnosis of MSA-p and PD.
出处
《放射学实践》
北大核心
2017年第6期602-607,共6页
Radiologic Practice
关键词
帕金森病
多系统萎缩
磁共振成像
胼胝体
Parkinson disease
Multiple system atrophy
Magnetic resonance imaging
Corpus callosum
