摘要
目的探讨扩散张量成像(DTI)及MRI扩散峰度成像(DKI)在帕金森病(PD)诊断中的价值。方法选取经本院确诊为PD患者,且进行DTI与DKI检查的患者64例为PD组,同期体检健康者60例为健康对照组。根据DTI扫描结果的相关参数FA和ADC、DKI扫描后参数MK和FA值,以ROC曲线评估相关参数对帕金森病的临床诊断价值。结果DTI参数ADC、FA值在红核、尾状核头、壳核各部位差异均无统计学意义(P>0.05),而在黑质中DTI参数FA值PD组低于健康对照组,差异具有统计学意义(P<0.05)。同时DKI扫描中,两组FA、MD值在黑质、红核、尾状核头、壳核、丘脑各部位差异均无统计学意义(P>0.05),而在黑质、丘脑中PD组MK值高于健康对照组,差异具有统计学意义(P<0.05)。同时ROC曲线显示,黑质DTI参数FA值、DKI参数MK值诊断PD的AUC为0.661、0.845,且敏感度、特异度黑质FA为43.8%、88.3%,黑质MK为75%、88.3%,DKI参数黑质MK对PD患者的诊断价值高于DTI参数黑质FA,具有一定预测价值。结论DTI成像对PD的诊断灵敏度较低,准确率较低,而DKI参数可有效评估PD患者脑深部核团微观变化情况,对PD具有一定的诊断价值,值得在临床上广泛推广。
Objective To explore the value of diffusion tensor MRI imaging(DTI)and MR diffusion kurtosis imaging(DKI)in the diagnosis of Parkinson's disease(PD).Methods A total of 64 patients diagnosed with PD in our hospital from December 2017 to September 2019,who underwent DTI and DKI examination,were selected as the study subjects for the PD group,and 60 healthy patients in the same period as the healthy control group.According to the FA,ADC,MK and FA values of DTI scan results,ROC curve was used to evaluate the clinical diagnostic value of relevant parameters for Parkinson's disease.Results There were no statistically significant differences in the values of DTI parameters ADC and FA in the red nucleus,caudate nucleus head and shell nucleus(P>0.05),while the values of DTI parameters in PD group in substantia nigra were lower than those in the healthy control group(P<0.05).Meanwhile,in the DKI scan,FA,MD values in the substantia nigra,red nucleus,caudate nucleus head,putamen nucleus and thalamus of the two groups showed no statistical significance(P>0.05),while MK values in the PD group were higher than those in the healthy control group(P<0.05).Meanwhile,the ROC curve showed that the AUC of PD diagnosed by DTI FA value and DKI MK value in substantia nigra was 0.661 and 0.845,and the sensitivity and specificity were FA in substantia nigra was 43.8%and 88.3%,and MK in substantia nigra was 75%and 88.3%.The diagnostic value of DKI MK in PD patients was higher than that of DTI FA,which had certain predictive value.Conclusion DTI imaging has a low diagnostic sensitivity and accuracy for PD,while DKI parameters can effectively evaluate the microscopic changes of deep cerebral nuclei in PD patients,which has a certain diagnostic value for PD and is worthy of wide promotion in clinical practice.
作者
刘莹
王红
马景旭
LIU Ying;WANG Hong;MA Jingxu(Imaging Department, the Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, P.R.China)
出处
《医学影像学杂志》
2020年第3期358-362,共5页
Journal of Medical Imaging
基金
新疆维吾尔自治区自然科学基金资助项目(编号:2019D01C227)。
关键词
帕金森病
磁共振成像
Parkinson's disease
Magnetic resonance imaging
