目的 探讨SWI对帕金森病(PD)的临床诊断价值.方法 将20例帕金森病患者分为早期PD组(n=13)和中晚期PD组(n=7),另选取14名性别、年龄与之匹配的健康志愿者为正常对照组.采用3.0T MR系统对各组中脑核团进行SWI,分别测量各核团相位值、宽度和中脑直径,计算宽度与中脑直径的比值(宽度/中脑直径),同时对PD患者进行Hoehn & Yahr分级,并对测量结果进行比较和相关性分析.结果 不同时期PD患者黑质致密带(SNc)相位值较正常人明显下降(P<0.01),中晚期PD组SNc、黑质网状带(SNr)相位值较早期PD组显著下降(P<0.01、P<0.05);早期PD组、中晚期PD组SNc宽度较正常对照组缩小(P<0.05、P<0.01),中晚期PD组SNc、SNr宽度较早期PD组明显缩小(P<0.01);中晚期PD组SNc宽度/中脑直径较正常对照组、早期PD组降低(P<0.01).PD患者SNc、SNr相位值与Hoehn & Yahr分级呈显著负相关(r=-0.602,P<0.01;r=-0.445,P<0.05),SNc、SNr宽度与Hoehn & Yahr分级呈显著负相关(r=-0.828,P<0.01;r=-0.667,P<0.01).PD患者SNc相位值与其宽度、宽度/中脑直径呈正相关(r=0.590,P<0.01;r=0.445,P<0.05),SNr相位值与其宽度呈正相关(r=0.493,P<0.05).结论应用SWI测量中脑核团相位值、宽度以及中脑核团宽度/中脑直径比值对评估PD具有临床诊断价值.%Objective To evaluate the measurement of phase value, width and the ratio of the width to the midbrain diameter of nuclei of midbrain in diagnosing Parkinson disease (PD) with susceptibility-weighted imaging (SWI). Methods The phase values, widths and diameters were measured in 20 patients with PD, including earlier-onset PD group (n= 13) and middle-later-onset PD group (n=7). Control group included 14 normal adults. The results of measurement were analyzed and compared, at the same time patients with PD were graded according to Hoehn & Yahr grading, and then correlation analysis was carried out among the phase value, width, the ratio and Hoehn & Yahr grading. Results Compared with control group, the phase values of sustantia nigra pars compacta (SNc) in earlier-onset PD group and middle-later-onset PD group significantly decreased (P＜0.01). The phase values of SNc and sustantia nigra pars reticulata (SNr) in middle-later-onset PD group significantly decreased compared with those in earlier-onset PD group (P＜0.01, P＜0. 05). Compared with control group, the widths of SNc in earlier-onset PD group and middle-later-onset PD group decreased (P＜0. 05, P＜0.01). The widths of SNc and SNr in middle-later-onset PD group significantly decreased compared with those in earlier-onset PD group (P＜0.01 ). Compared with control group and earlier-onset PD group, the SNc width/midbrain diameter in middle-later-onset PD group decreased (P＜0. 01). In PD patients, the phase values of SNc and SNr were negatively correlated with Hoehn & Yahr grading (r=-0.602, P＜0.01; r= -0.445, P＜0. 05), the widths of SNc and SNr negatively correlated with Hoehn & Yahr grading (r= -0.828, P＜0.01; r=-0.667, P＜0. 01), the phase value of SNc positively correlated with the width and width/midbrain diameter (r = 0. 590, P＜ 0. 01; r= 0. 445, P＜ 0. 05), the phase value of SNr positively correlated with the width (r=0. 493, P＜0.05). Conclusion Measurement of phase value, width and the ratio of the width to the midbrain diameter of nuclei of midbrain with SWI is reliable to diagnose PD.
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