Oikawa Hirobumi, Sasaki Makoto, Tamakawa Yoshiharu, Ehara Shigeru, Tohyama Koujiro
Department of Radiology, Iwate Medical University, Uchimaru, Morioka, Japan.
AJNR Am J Neuroradiol. 2002 Nov-Dec;23(10):1747-56.
A reduction in the area of the substantia nigra (SN) has been shown in patients with Parkinson disease. The substantia nigra is anteroinferolateral to the red nucleus, and it is important to precisely locate its true anatomic location to accurately measure SN area. Our purpose was to determine the exact location of the substantia nigra by correlating imaging and anatomic findings. We also attempted to quantitate SN area in patients with Parkinson disease compared with that in healthy control subjects on the basis of proton density-weighted spin-echo (SE) and fast short inversion time inversion-recovery (STIR) MR imaging findings.
In four healthy volunteers, dual-echo SE and fast STIR MR images were obtained in three orthogonal planes and an oblique coronal plane. These images were correlated with anatomic specimens to determine the location of the SN. The area of the SN was also measured on oblique coronal fast STIR images obtained at a plane perpendicular to the SN in 22 patients with Parkinson disease and in 22 age- and sex-matched healthy volunteers.
The true anatomic location of the SN, anteroinferolateral to the red nucleus, was accurately identified, not on T2-weighted images, but on proton density-weighted SE images and fast STIR images as an area of hyperintense gray matter. The hypointense area seen on T2-weighted images corresponded to the anterosuperior aspect of the SN and to the adjacent crus cerebri. No statistically significant differences were noted in the size of the SN when the oblique coronal images of patients with Parkinson disease were compared with those of the control groups.
The SN is located mainly beneath the red nucleus. Its location cannot be determined on the basis of T2-weighted imaging results but rather on the basis of proton density-weighted SE or fast STIR findings. SN volume loss is not found in Parkinson disease, and this finding is compatible with that of recent pathology reports in the literature.
帕金森病患者已出现黑质（SN）面积减小的情况。黑质位于红核的前下外侧，准确确定其真实解剖位置对于精确测量SN面积很重要。我们的目的是通过关联影像学和解剖学发现来确定黑质的确切位置。我们还试图根据质子密度加权自旋回波（SE）和快速短反转时间反转恢复（STIR）磁共振成像结果，对帕金森病患者与健康对照者的SN面积进行定量分析。
对4名健康志愿者，在三个正交平面和一个斜冠状平面上获取双回波SE和快速STIR磁共振图像。将这些图像与解剖标本相关联以确定SN的位置。还在22例帕金森病患者和22例年龄及性别匹配的健康志愿者中，于垂直于SN的平面上获取的斜冠状快速STIR图像上测量SN的面积。
准确识别出SN的真实解剖位置，即位于红核的前下外侧，不是在T2加权图像上，而是在质子密度加权SE图像和快速STIR图像上表现为高信号灰质区域。T2加权图像上的低信号区域对应于SN的前上部分及相邻的大脑脚。将帕金森病患者的斜冠状图像与对照组的图像进行比较时，SN大小未发现统计学上的显著差异。
SN主要位于红核下方。其位置不能根据T2加权成像结果确定，而应根据质子密度加权SE或快速STIR结果来确定。帕金森病中未发现SN体积减小，这一发现与文献中近期的病理学报告一致。
