实用临床医药杂志2025，Vol.29Issue(8)：1-5,5.DOI:10.7619/jcmp.20245390
磁敏感加权成像测量帕金森病伴冻结步态患者基底节区特征及铁沉积量研究
Susceptibility-weighted imaging for measuring characteristics of basal ganglia and iron deposition in Parkinson's disease patients with freezing of gait
摘要
Abstract
Objective To measure changes in the basal ganglia volume,characteristics of neu-romelanin in substantia nigra-1 and iron deposition using susceptibility-weighted imaging(SWI)in Parkinson's disease(PD)patients with freezing of gait at different stages,and to explore their value in evaluating these stages.Methods A total of 178 PD patients with freezing of gait were enrolled.According to Hoehn-Yahr stage,the patients were divided into stage Ⅰ to Ⅱ group(112 cases)and divided into stage Ⅲ to Ⅴ group(66 cases).Additionally,70 healthy volunteers undergoing routine physical examinations were randomly selected as control group.SWI was used to measure basal gan-glia volumes(globus pallidus,putamen and caudate nucleus),disappearance rate of substantia nigra-1(including bilateral display,unilateral display and bilateral non-display),and iron deposition(phase shift values)among groups.Multivariate logistic regression analysis was conducted to identify imaging factors associated with different stages.Receiver operating characteristic(ROC)curve analy-sis was performed to calculate the area under the curve(AUC)for assessing the predictive perform-ance of imaging factors.Results The course of disease in stage Ⅲ to Ⅴ group was significantly lon-ger,and the Parkinson's Comprehensive Assessment Scale(UPDRS)score was significantly higher than that in stage Ⅰ to Ⅱ group(P＜0.05).The volume of pallidum,putamen and caudate nucleus in stage Ⅰ to Ⅱ and stage Ⅲ to Ⅴ groups were significantly lower,and those in stage Ⅲ to Ⅴgroup were significantly lower than that in stage Ⅰ to Ⅱ group(P＜0.05);the disappearance rate of substantia nigra-1 and the deposition amount of pallidum iron,putaminal iron as well as caudate i-ron in stage Ⅰ to Ⅱ and stage Ⅲ to Ⅴ groups were significantly higher,and those in stage Ⅲ to Ⅴgroup were significantly higher than that in stage Ⅰ to Ⅱ group(P＜0.05).Logistic regression analysis indicated that decreased caudate nucleus volume(OR=1.856,95％CI,1.234 to 2.564,P＜0.001),disappearance of substantia nigra-1(OR=2.235,95％CI,1.657 to 2.659,P＜0.001)and increased iron deposition in the globus pallidus(OR=1.562,95％CI,1.234 to 1.989,P＜0.001)were predictors of Hoehn-Yahr staging.ROC showed that the AUC of Hoehn-Yahr stage was 0.889 based on the combination of caudate volume,disappearance of substantia nigra-1 and depo-sition of pallidum.Conclusion SWI is an important non-invasive imaging tool for assessing different stages in PD patients with freezing of gait.Caudate nucleus volume,substantia nigra-1 and iron depo-sition in the globus pallidus are key indicators for predicting Hoehn-Yahr staging.关键词
帕金森病/冻结步态/磁敏感加权成像/基底节区/黑质小体-1/铁沉积量/Hoehn-Yahr分期/尾状核体积Key words
parkinson's disease/freezing of gait/susceptibility-weighted imaging/basal gan-glia/substantia nigra-1/iron deposition/stage of Hoehn-Yahr/caudate nucleus volume分类
临床医学引用本文复制引用
聂聪科,马景旭..磁敏感加权成像测量帕金森病伴冻结步态患者基底节区特征及铁沉积量研究[J].实用临床医药杂志,2025,29(8):1-5,5.基金项目
新疆维吾尔自治区自然科学基金(2022D01C272) （2022D01C272）
