摘要
目的分析帕金森病(Parkinson's disease,PD)患者的脑白质高信号(white matter hyperintensities,WMH)及^(11)C-甲基-N-2β-甲基酯-3β-(4-氟苯基)托烷[2β-carbomethoxy-3β-(4-fluorophenyl)-(N-^(11)C-methyl)tropane,CFT]正电子发射断层显像(positron emission tomography,PET)/CT成像特征,并探讨两者间的关系。方法回顾性选取2021年3月至2025年3月上海交通大学医学院附属仁济医院神经内科就诊的PD患者84例,根据PD患者年龄分为非老年组(33例)和老年组(51例,年龄>65岁);依据PD患者的WMH程度分为无WMH组(22例)和WMH组(62例)。进行脑白质病变程度评分,包括脑室周围白质高信号(periventricular WMH,PVH)评分和深部WMH(deep WMH,DWMH)评分。所有患者进行头部MRI和^(11)C-CFT-PET/CT检查,计算T/N值和不对称指数。结果老年组H-Y分级明显高于非老年组,双侧尾状核、双侧前壳核、对侧后壳核T/N和后壳核不对称指数明显低于非老年组(P<0.05,P<0.01)。WMH组H-Y分级和年龄明显高于无WMH组,双侧尾状核、双侧前壳核、双侧后壳核T/N和后壳核不对称指数明显低于无WMH组(P<0.05,P<0.01)。PVH评分与起病侧尾状核T/N(r=-0.282,P=0.009)、对侧尾状核T/N(r=-0.215,P=0.049)、起病侧前壳核T/N(r=-0.249,P=0.022)、对侧前壳核T/N(r=-0.280,P=0.010)、对侧后壳核T/N(r=-0.285,P=0.009)呈负相关,DWMH评分与起病侧尾状核T/N、起病侧前壳核T/N呈负相关(P<0.05)。结论年龄和疾病严重程度影响PD患者的WMH和多巴胺神经系统,WMH负荷增加与多巴胺能神经系统损伤有关。
Objective To analyze white matter hyperintensities(WMH)and ^(11)C-CFT PET/CT characteristics in patients with PD,and explore their relationship.Methods A total of 84 PD patients admitted to our department between March 2021 and March 2025 were retrospectively enrolled,and they were divided into young group(33 cases)and elderly group(aged>65 years,51 cases)and also into non-WMH group(22 cases)and WMH group(62 cases)based on the severity of WMH.The degree of white matter lesions was scored,including periventricular white matter hyperintense(PVH)score and deep white matter hyperintense(DWMH)score.All patients underwent head MRI and ^(11)C-CFT-PET/CT scanning.The T/N value and asymmetry index were calculated.Results The elderly PD patients exhibited significantly advanced age and higher H-Y stages,but lower T/N values of affected side of caudate nucleus,contralateral caudate nucleus,affected side of anterior putamen,contralateral anterior putamen and contralateral posterior putamen,and posterior putamen asymmetry index than the young patients(P<0.05,P<0.01).Similar results were observed in the WMH group when compared with the non-WMH group(P<0.05,P<0.01).The PVH score was negatively correlated with the T/N values of affected side of caudate nucleus(r=—0.282,P=0.009),contralateral caudate nucleus(r=-0.215,P=0.049),affected side of anterior putamen(r=-0.249,P=0.022),contralateral anterior putamen(r=-0.280,P=0.010)and contralateral posterior putamen(r=-0.285,P=0.009),and DWMH score was also negatively correlated with the T/N values in the affected side of caudate nucleus and affected side of anterior putamen(P<0.05).Conclusion Both age and disease severity impact WMH and dopaminergic system in PD patients.A higher WMH load is associated with dopaminergic neuronal damage.
作者
李宛霖
关爱
谢心怡
杜芸兰
戴若莲
卢钟娇
陈刚
董青
王华龙
王刚
Li Wanlin;Guan Ai;Xie Xinyi;Du Yunlan;Dai Ruolian;Lu Zhongjiao;Chen Gang;Dong Qing;Wang Hualong;Wang Gang(Department of Neurology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)
出处
《中华老年心脑血管病杂志》
北大核心
2025年第10期1304-1308,共5页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
国家自然科学基金(82271462,82371416)。
关键词
帕金森病
脑白质病
正电子发射断层显像术
Parkinson disease
leukoencephalopathies
positron-emission tomography
