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目的探讨脑深部灰质核团MRT2值在帕金森病(PD)中的诊断价值及意义。资料与方法选取PD患者20例和对照组10名,分别对黑质、红核、尾状核、壳核、丘脑进行MRI扫描,根据Block方程求T2值,对两组各核团T2值采用成组设计定量资料是否呈正态分布、方差是否齐性,选择t检验、近似t检验;PD患侧黑质T2值与疾病分期进行相关分析;采用随机成组设计对不同分期(1～2期、2.5～3期、4期)PD组患侧感兴趣区(ROI)T2值进行组间比较,P<0.05有统计学意义。结果(1)20例PD组患侧黑质与10名对照组黑质T2值比较有统计学意义(P<0.05),PD组黑质T2值(29.65±3.41)较对照组黑质T2值(32.45±1.78)明显减低;PD组患侧红核、尾状核、壳核及丘脑ROI与对照组ROI无明显统计学意义(P>0.05)。(2)PD组患侧黑质T2值与疾病不同分期呈负相关性(r=-0.733)。(3)不同分期(1～2期、2.5～3期、4期)PD组患侧黑质T2值有统计学意义(P<0.05),且T2值逐渐减低;壳核在2.5～3期与4期有统计学意义(P<0.05),且表现为2.5～3期T2值减低(31.74±2.80),4期壳核T2值增高(36.74±0.63);丘脑1～2期与4期T2值有统计学意义(P<0.05)。结论(1)PD组患侧黑质T2值较对照组减低,提示PD患侧黑质脑铁病理性沉积。(2)PD组患侧黑质T2值与不同分期呈负相关性,提示PD患侧黑质脑铁沉积与疾病严重程度呈负相关性。(3)不同分期(1～2期、2.5～3期、4期)PD患侧黑质T2值明显减低,反映不同分期黑质脑铁病理性沉积不同,且随疾病的严重程度而增多;PD患侧壳核T2值从减低到增加,提示壳核脑铁沉积呈增加到减低的动态过程;4期PD患侧丘脑T2值减低,提示丘脑脑铁沉积可能是PD晚期表现。
Objective To investigate the diagnostic value and significance of MRT2 in brain deep gray matter nuclei in Parkinson’s disease (PD). Materials and Methods Twenty patients with PD and 10 control subjects were enrolled in this study. The substantia nigra, red nucleus, caudate nucleus, putamen and thalamus were scanned by MRI. T2 value was calculated according to block equation. Group design quantitative data were normal distribution, the variance is homogeneous, select the t test, approximate t test; PD ipsilateral substantia nigra T2 value and disease stage correlation analysis; randomized group design for different stages (1 ~ 2 Period, 2.5 to 3, 4) PD group of interest area (ROI) T2 values were compared between groups, P <0.05 was statistically significant. Results (1) The T2 value of substantia nigra in 20 PD group was significantly higher than that of the control group (P <0.05), the T2 value of substantia nigra in PD group was (29.65 ± 3.41) (32.45 ± 1.78) in PD group. There was no significant difference in the ROI of the nucleus accumbens, caudate nucleus, putamen, thalamus and control group in PD group (P> 0.05). (2) The T2 value of ipsilateral substantia nigra in PD group was negatively correlated with different stages of disease (r = -0.733). (3) The T2 value of substantia nigra in PD group was statistically significant (P <0.05) in different stages (1-2 stage, 2.5-3 stage, and 4 stage), and the T2 value decreased gradually. The putamen in 2.5-3 stage (P <0.05), and the T2 values decreased from 2.5 to 3 (31.74 ± 2.80) and the values of T2 in the fourth stage putamen increased (36.74 ± 0.63) T2 value was statistically significant (P <0.05). Conclusions (1) T2 lesion in the ipsilateral substantia nigra in PD group is lower than that in control group, suggesting pathological deposition of brain iron in substantia nigra of PD. (2) The T2 value of ipsilateral substantia nigra in PD group was negatively correlated with different stages, suggesting that the iron deposition in substantia nigra of PD had a negative correlation with the severity of disease. (3) The T2 lesion value of PD in patients with different stages (1-2 stage, 2.5-3 stage, and 4 stage) was significantly decreased, reflecting the different pathological deposition of substantia nigra in different stages and increased with the severity of the disease; The T2 value of putamen in PD increased from reduced to increased, which suggested that the iron deposition in the putamen increased and decreased dynamically. The decrease of T2 value in the PD rat hypothalamus in the fourth phase suggested that the deposition of brain iron in the thalamic brain may be the late manifestation of PD.