早期帕金森病相关脑结构的定量磁化率成像

庄晗; 刘学玲; 秦春丽; 王辉; 李郁欣; 李文生; 史勇红

doi:10.16098/j.issn.0529-1356.2020.05.017

PDF(3464 KB)

解剖学报 ›› 2020, Vol. 51 ›› Issue (5) : 738-744. DOI: 10.16098/j.issn.0529-1356.2020.05.017

神经生物学

早期帕金森病相关脑结构的定量磁化率成像

庄晗^1,2,3 刘学玲⁴ 秦春丽^2,3王辉^1,2,3李郁欣⁴ 李文生^1,2,3* 史勇红^2,3*

作者信息 +

Quantitative susceptibility mapping of early-stage Parkinson’s disease related brain structure#br#

ZHUANG Han^1,2,3 LIU Xue-ling⁴QIN Chun-li^2,3 WANG Hui^1,2,3 LI Yu-xin⁴ LI Wen-sheng^1,2,3* SHI Yong-hong^2,3*

Author information +

文章历史 +

摘要

目的应用3T磁共振T1加权成像和定量磁化率成像分析早期帕金森病（PD）患者深部灰质核团体积的变化，探究深部灰质核团磁化率值在帕金森病患者和健康对照者之间的差异，探讨磁化率值在早期PD诊断中的意义，以及定量磁化率成像对于黑质小体-1的显示情况。方法 30例早期PD患者和27例年龄、性别、教育程度匹配的健康对照者，分割双侧尾状核、壳核、苍白球、黑质和红核，测量核团的体积和平均磁化率值，使用SPSS 20.0软件对数据进行统计学分析，并对磁化率值进行逻辑回归。结果早期PD患者组和健康对照组上述核团标准化体积之间差异无显著性；早期PD患者组右侧苍白球、左侧黑质和右侧黑质的磁化率值显著高于健康对照组（P<0.05）；上述核团磁化率值经逻辑回归变换后得到的受试者工作特征曲线下面积为0.93；在21例健康对照者和1例早期PD患者的定量磁化率图像上看到了黑质小体-1。结论定量磁化率图像在诊断早期PD中具有很高的应用价值；大部分健康对照者的黑质小体-1在定量磁化率图像上可以显示，但更精确的研究需要<1mm分辨率的定量磁化率图像。

Abstract

Objective Using 3T T1 weighted magnetic resonance imaging and quantitative susceptibility mapping to analyse the early-stage Parkinson’s disease (PD) patients’volume and susceptibility value changes of deep gray matter nuclei, and to explore the significance of susceptibility values in diagnosis of early-stage PD, as well as observability of nigrosome-1 in this study.

Methods 3.0T MRI scans were performed in 30 early-stage PD patients and 27 age-, sex- and education matched healthy controls. Bilateral caudate, putamen, globus pallidus, substantia nigra and red nucleus were segmented. Their volumes and susceptibility values were calculated. SPSS 20.0 software was used to analyze the differences between the two groups. We also performed a logistic regression using the susceptibility values. Results There was no difference in the standardized volume of the above nuclei between the early-stage PD patients and the healthy controls. The susceptibility values of the right globus pallidus, the left substantia nigra and the right substantia nigra (P<0.05) in the early-stage Parkinson’s disease group were significantly higher than those in the healthy controls. The area under the receiver operating characteristic curve obtained by logistic regression using susceptibility values was 0.93. Nigrosome-1 was seen in 21 healthy controls and 1 early-stage PD patient. Conclusion As a marker of early diagnosis of PD, the susceptibility value has high application value. Nigrosome-1 in most healthy controls can be displayed on quantitative susceptibility images, but more accurate studies of nigrosome-1 require quantitative susceptibility mapping at submillimeter resolution.

导出引用

庄晗刘学玲秦春丽王辉李郁欣李文生史勇红. 早期帕金森病相关脑结构的定量磁化率成像[J]. 解剖学报. 2020, 51(5): 738-744 https://doi.org/10.16098/j.issn.0529-1356.2020.05.017

ZHUANG Han LIU Xue-ling QIN Chun-li WANG Hui LI Yu-xin LI Wen-sheng SHI Yong-hong. Quantitative susceptibility mapping of early-stage Parkinson’s disease related brain structure#br#[J]. Acta Anatomica Sinica. 2020, 51(5): 738-744 https://doi.org/10.16098/j.issn.0529-1356.2020.05.017

中图分类号： R322.81

参考文献

［1］ Sian-Hülsmann J, Mandel S, Youdim MBH, et al. The relevance of iron in the pathogenesis of Parkinson’s disease ［J］. J Neurochem, 2011, 118(6):939-957.
［2］ Eskreis-Winkler S, Zhang Y, Zhang J, et al. The clinical utility of QSM: disease diagnosis, medical management, and surgical planning ［J］. NMR Biomed, 2017, 30(4):e3668.
［3］ Li W, Wu B, Liu CL. STI suite: a software package for quantitative susceptibility imaging ［C］. Proc Intl Soc Mag Reson Med, 2014, 22(2014):3265.
［4］ Tustison NJ, Avants BB, Cook PA, et al. N4ITK: improved N3 bias correction ［J］. IEEE Trans Med Imaging, 2010, 29(6):1310-1320.
［5］ Smith SM, Jenkinson M, Woolrich MW, et al. Advances in functional and structural MR image analysis and implementation as FSL ［J］. NeuroImage, 2004, 23(Suppl 1):S208-S219.
［6］ Feng X, Deistung A, Dwyer MG, et al. An improved FSL-FIRST pipeline for subcortical gray matter segmentation to study abnormal brain anatomy using quantitative susceptibility mapping (QSM) ［J］. Magn Reson Imaging, 2017, 39:110-122.
［7］ Avants BB, Tustison N, Song G. Advanced normalization tools (ANTS) ［J］. Insight J, 2009, 2:1-35.
［8］ Avants BB, Tustison NJ, Song G, et al. A reproducible evaluation of ANTs similarity metric performance in brain image registration ［J］. NeuroImage, 2011, 54(3):2033-2044.
［9］ Dice LR. Measures of the amount of ecologic association between species ［J］. Ecology, 1945, 26(3):297-302.
［10］ He N, Ling H, Ding B, et al. Region-specific disturbed iron distribution in early idiopathic Parkinson’s disease measured by quantitative susceptibility mapping ［J］. Hum Brain Mapp, 2015, 36(11):4407-4420.
［11］ Lee SH, Kim SS, Tae WS, et al. Regional volume analysis of the parkinson disease brain in early disease stage: gray matter, white matter, striatum, and thalamus ［J］. AJNR, 2011, 32(4):682-687.
［12］ Pitcher TL, Melzer TR, MacAskill MR, et al. Reduced striatal volumes in Parkinson’s disease: a magnetic resonance imaging study ［J］. Transl Neurodegener, 2012, 1(1):1-8.
［13］ Liu GX, Shi YH, Wang ShQ, et al. Differential analysis of brain structure volume associated with Parkinson s disease based on nuclear magnetic resonance T1 imaging ［J］. Acta Anatomica Sinica, 2018,49(3):78-85.(in Chinese)
刘桂雪, 史勇红, 王士卿, 等. 基于磁共振T1成像的帕金森病相关脑结构体积差异性分析［J］. 解剖学报, 2018, 49(3):78-85.
［14］ Zecca L, Stroppolo A, Gatti A, et al. The role of iron and copper molecules in the neuronal vulnerability of locus coeruleus and substantia nigra during aging ［J］. Proc Natl Acad Sci USA, 2004, 101 (26): 9843-9848.
［15］ Deistung A, Sch?fer A, Schweser F, et al. Toward in vivo histology: a comparison of quantitative susceptibility mapping (QSM) with magnitude-, phase-, and R2* -imaging at ultra-high magnetic field strength ［J］. NeuroImage, 2013, 65(2013):299-314.
［16］ Langkammer C, Schweser F, Krebs N, et al. Quantitative susceptibility mapping (QSM) as a means to measure brain iron? A post mortem validation study ［J］. Neuroimage, 2012, 62(3):1593-1599.
［17］ Dexter DT, Wells FR, Agid F, et al. Increased nigral iron content in postmortem parkinsonian brain ［J］. The Lancet, 1987, 330(8569):1219-1220.
［18］ Griffiths PD, Crossman AR. Distribution of iron in the basal ganglia and neocortex in postmortem tissue in Parkinson’s disease and Alzheimer’s disease ［J］. Dement Geriatr Cogn, 1993, 4(2):61-65.
［19］ Dusek P, Roos PM, Litwin T, et al. The neurotoxicity of iron, copper and manganese in Parkinson’s and Wilson’s diseases ［J］. J Trace Elem Med Biol, 2015, 31(2015):193-203.
［20］ Murakami Y, Kakeda S, Watanabe K, et al. Usefulness of quantitative susceptibility mapping for the diagnosis of Parkinson disease ［J］. AJNR, 2015, 36(6):1102-1108

［21］ Langkammer C, Pirpamer L, Seiler S, et al. Quantitative susceptibility mapping in Parkinson’s disease ［J］. PLoS One, 2016, 11(9):e0162460.

［22］ Lotfipour AK, Wharton S, Schwarz ST, et al. High resolution magnetic susceptibility mapping of the substantia nigra in Parkinson’s disease ［J］. J Magn Reson Imaging, 2012, 35(1):48-55.

［23］ Guan X, Xuan M, Gu Q, et al. Influence of regional iron on the motor impairments of Parkinson’s disease: a quantitative susceptibility mapping study ［J］. J Magn Reson Imaging, 2017, 45(5):1335-1342.
［24］ Dickson DW, Braak H, Duda JE, et al. Neuropathological assessment of Parkinson’s disease: refining the diagnostic criteria ［J］. Lancet Neurol，2009, 8(12):1150-1157.
［25］ Amoroso N, Rocca ML, Monaco A, et al. Complex networks reveal early MRI markers of Parkinson’s disease ［J］. Med Image Anal, 2018, 48:12-24.
［26］ Schwarz ST, Afzal M, Morgan PS, et al. The‘swallow tail’ appearance of the healthy nigrosome-a new accurate test of Parkinson’s disease: a case-control and retrospective cross-sectional MRI study at 3T ［J］. PLoS One, 2016, 9(4):e93814.