实用临床医药杂志2025，Vol.29Issue(12)：1-5,12,6.DOI:10.7619/jcmp.20244525
扩散峰度成像联合酰胺质子转移序列评估帕金森病伴冻结步态患者的脑灰质核团改变
Evaluation of pathological changes in gray matter nuclei of brain in Parkinson's disease patients with freezing of gait using magnetic resonance diffusion kurtosis imaging and amide proton transfer sequence
摘要
Abstract
Objective To evaluate the pathological changes in grey matter nuclei of brain of Par-kinson's disease patients with freezing of gait using magnetic resonance diffusion kurtosis imaging(DKI)combined with amide proton transfer(APT)sequences.Methods A total of 92 Parkinson's disease patients were enrolled as observation group,including 42 patients with freezing of gait and 50 without freezing of gait.An additional 50 healthy individuals were enrolled as control group.All partic-ipants underwent brain scans using a 3.0T MRI system with conventional sequences,DKI and APT protocols.Post processing was performed to delineate regions of interest in bilateral substantia nigra,red nucleus,globus pallidus,caudate nucleus and putamen.DKI parameters included fractional ani-sotropy(FA),mean diffusivity(MD),mean kurtosis(MK),axial kurtosis(Ka)and kurtosis radial(Kr),and APT parameter was asymmetric magnetization transfer rate of amide protons(MTRasym).Results In the affected side of the observation group,MK and Kr values in the substantia nigra,red nucleus,globus pallidus,caudate nucleus and putamen were significantly higher than those in the control group(P＜0.05).In the observation group,MK values in the substantia nigra were significantly higher in patients with freezing of gait compared to those without(P＜0.05).MTRasym values in the affected substantia nigra,red nucleus,globus pallidus,caudate nucleus and putamen were also significantly elevated in the observation group compared to the control group(P＜0.05).MTRasym values in the affected substantia nigra were significantly higher in patients with freezing of gait than those without(P＜0.05).Receiver operating characteristic(ROC)curve analysis showed that MK,Kr and MTRasym values in the affected substantia nigra had significantly larger area under the curve(AUC)for diagnosing Parkinson's disease compared to other grey matter nuclei(P＜0.05).The AUC of the MK value of the substantia nigra on the affected side combined with MTRasym in di-agnosing frozen gait in the observation group was significantly larger than that of single index(P＜0.05).Conclusion Magnetic resonance DKI and APT sequences can provide more characteristics of pathological changes in brain gray matter nuclei associated with Parkinson's disease and frozen gait.Among them,the MK value of the affected substantia nigra combined with MTRasym has im-portant application potential in assisting the clinical diagnosis of Parkinson's disease with frozen gait.关键词
帕金森病/冻结步态/磁共振成像/扩散峰度成像/酰胺质子转移/平均扩散峰度/径向峰度/脑灰质核团Key words
Parkinson's disease/freezing of gait/magnetic resonance imaging/diffusion kurtosis imaging/amide proton transfer/mean diffusivity/kurtosis radial/gray matter nuclei of the brain分类
医药卫生引用本文复制引用
陆鹏,刘莹,努尔比亚·克然木..扩散峰度成像联合酰胺质子转移序列评估帕金森病伴冻结步态患者的脑灰质核团改变[J].实用临床医药杂志,2025,29(12):1-5,12,6.基金项目
省部共建中亚高发病成因与防治国家重点实验室开放课题(SKL-HIDCA-2023-EF8) （SKL-HIDCA-2023-EF8）
