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目的探讨多回波采集T2WI三维梯度回波(ESWAN)技术在定量分析成人原发性不宁腿综合征(RLS)患者脑内灰质核团铁含量改变及其与国际不宁腿综合征研究组(IRLS)评分的相关性,评估其与RLS患者病情程度的敏感性与特异性。方法使用GE Signa Excite HD 3.0 T超导磁共振扫描仪对符合RLS临床诊断标准的35例患者和与35名相匹配的健康志愿者行ESWAN及常规扫描。应用GE Medical Systems Functool 4.4工作站软件进行图像后处理,并测得相应的幅度值和相位值。采用独立样本t检验比较RLS组和对照组实验数据,并与RLS组患者临床评分进行双变量相关分析(Pearson相关),采用受试者工作特征曲线(ROC)曲线下面积(AUC)对RLS患者病情程度敏感性比较。结果 (1)与对照组比较,RLS组的红核(P=0.004)、黑质致密部(P=0.002)、丘脑(P=0.027)差异具有统计学意义。(2)与临床评分的相关性分析:红核(r=0.836,P=0.000)、黑质致密部(r=0.763,P=0.000)、丘脑(r=0.797,P=0.000)的幅度log值与临床评分具有相关性,即与RLS的病情呈正相关。丘脑的相位值与临床评分具有正性相关(r=0.399,P=0.018)。(3)以丘脑的幅度log值绘制的AUC最大为0.949。结论 ESWAN技术能定量评价RLS患者脑内灰质核团铁含量变化、评估病情程度等,为临床诊疗提供更多信息。
Objective To investigate the changes of iron content in the gray matter nucleus of brain in patients with adult primary restless legs syndrome (RLS) by multi-echo acquired T2WI three-dimensional gradient echo (ESWAN) technique and its relationship with the restless legs syndrome (IRLS) score to assess its sensitivity and specificity to the severity of the condition in patients with RLS. Methods 35 patients with RLS clinical criteria and 35 matched healthy volunteers underwent ESWAN and routine scans using the GE Signa Excite HD 3.0 T superconducting magnetic resonance scanner. The images were processed using the GE Medical Systems Functool 4.4 workstation software and the corresponding amplitude and phase values were measured. The independent sample t-test was used to compare the experimental data of RLS group and control group with the two-variable correlation analysis (Pearson correlation) of RLS patients clinical scores. The area under curve of receiver operating characteristic (ROC) Comparison of the severity of the disease. Results (1) Compared with the control group, there were significant differences in RLS group (P = 0.004), substantia nigra pars compacta (P = 0.002) and thalamus (P = 0.027) (2) Correlation analysis with clinical score showed that the amplitude log of the nucleus (r = 0.836, P = 0.000), substantia nigra pars compacta (r = 0.763, P = 0.000) The value was correlated with the clinical score, which was positively correlated with the condition of RLS. The phase of thalamus was positively correlated with clinical score (r = 0.399, P = 0.018). (3) The maximum AUC of the thalamus amplitude log is 0.949. Conclusion The ESWAN technique can quantitatively evaluate the changes of iron content in the gray matter nucleus of the brain in RLS patients and assess the severity of the disease so as to provide more information for clinical diagnosis and treatment.