Zhang Guohua, Zhang Yuhu, Zhang Chengguo, Wang Yukai, Ma Guixian, Nie Kun, Xie Haiqun, Liu Jianping, Wang Lijuan
Southern Medical University, Guangzhou, Guangdong 510515, China; Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, China; Department of Neurology, The First People's Hospital of Foshan, Foshan, Guangdong 528000, China.
Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, China.
Parkinsons Dis. 2015;2015:207624. doi: 10.1155/2015/207624. Epub 2015 Dec 3.
Background. To diagnose Parkinson disease (PD) in an early stage and accurately evaluate severity, it is important to develop a sensitive method for detecting structural changes in the substantia nigra (SN). Method. Seventy-two untreated patients with early PD and 72 healthy controls underwent diffusion tensor and diffusion kurtosis imaging. Regions of interest were drawn in the rostral, middle, and caudal SN by two blinded and independent raters. Mean kurtosis (MK) and fractional anisotropy in the SN were compared between the groups. Receiver operating characteristic (ROC) and Spearman correlation analyses were used to compare the diagnostic accuracy and correlate imaging findings with Hoehn-Yahr (H-Y) staging and part III of the Unified Parkinson's Disease Rating Scale (UPDRS-III). Result. MK in the SN was increased significantly in PD patients compared with healthy controls. The area under the ROC curve was 0.976 for MK in the SN (sensitivity, 0.944; specificity, 0.917). MK in the SN had a positive correlation with H-Y staging and UPDRS-III scores. Conclusion. Diffusion kurtosis imaging is a sensitive method for PD diagnosis and severity evaluation. MK in the SN is a potential biomarker for imaging studies of early PD that can be widely used in clinic.
背景。为了早期诊断帕金森病（PD）并准确评估其严重程度，开发一种检测黑质（SN）结构变化的敏感方法很重要。方法。72例未经治疗的早期PD患者和72名健康对照者接受了扩散张量成像和扩散峰度成像。由两名独立的盲法评估者在SN的头侧、中间和尾侧绘制感兴趣区域。比较两组SN中的平均峰度（MK）和分数各向异性。采用受试者工作特征（ROC）分析和Spearman相关性分析比较诊断准确性，并将影像学结果与Hoehn-Yahr（H-Y）分期及统一帕金森病评定量表第三部分（UPDRS-III）进行相关性分析。结果。与健康对照相比，PD患者SN中的MK显著增加。SN中MK的ROC曲线下面积为0.976（敏感性为0.944；特异性为0.917）。SN中的MK与H-Y分期和UPDRS-III评分呈正相关。结论。扩散峰度成像对于PD诊断和严重程度评估是一种敏感方法。SN中的MK是早期PD影像学研究的潜在生物标志物，可在临床上广泛应用。
