Ji Suqiong, Zhang Shun, Mao Zhijuan, Han Haiyan, Yang Qingmei, Zhu Wenzhen, Zhu Suiqiang, Xue Zheng
Department of Neurology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, P.R China.
Neurol India. 2016 May-Jun;64(3):428-35. doi: 10.4103/0028-3886.181532.
It has been reported that R2* is a sensitive marker for iron deposition. The aim of this study was to quantitatively assess iron deposition in Parkinson's disease (PD) using changes of R2* in enhanced T2 star-weighted angiography (ESWAN) and to discuss the value of ESWAN for PD.
Fifty-four primary PD patients and twenty-eight healthy individuals were examined by ESWAN in the 3·0 T magnetic resonance imaging system. The R2* values were measured from the deep gray nuclei (including the substantia nigra [SN], red nuclei, globus pallidus, putamina, caudate nuclei, and thalami). The unified PD rating scale (UPDRS) III assessment, the nonmotor symptoms scale (NMSS), and the mini mental state examination (MMSE) were used to rate all the patients.
The comparison of the R* values between the deep gray nuclei on the same side of the PD patients and the control group revealed significant differences in the SN and red nuclei (P < 0.05). There was a significant difference between Hoehn and Yahr (HY) 1 and HY2-4 patients in terms of the values of the SN. There was a slight correlation between the R* values of the SN of the PD patients (HY >1) and the UPDRS III ratings. No correlation between the R* signal values in the PD patients and the NMSS and MMSE scales was found.
Iron concentrations in the regions of interest may represent the severity of the PD motor symptoms, and whether they are related to the nonmotor symptoms remains a question for further investigation. ESWAN offers special advantages in determining iron depositions in the brain and in enabling a sensitive diagnosis of PD, although further study is necessary.
据报道，R2是铁沉积的敏感标志物。本研究旨在利用增强T2加权血管造影（ESWAN）中R2*的变化定量评估帕金森病（PD）中的铁沉积，并探讨ESWAN对PD的价值。
在3.0T磁共振成像系统中，对54例原发性PD患者和28名健康个体进行ESWAN检查。从深部灰质核团（包括黑质[SN]、红核、苍白球、壳核、尾状核和丘脑）测量R2*值。使用统一PD评定量表（UPDRS）III评估、非运动症状量表（NMSS）和简易精神状态检查（MMSE）对所有患者进行评分。
PD患者同侧深部灰质核团与对照组之间R值比较，SN和红核存在显著差异（P<0.05）。SN值在Hoehn和Yahr（HY）1期和HY2 - 4期患者之间存在显著差异。PD患者（HY>1）SN的R值与UPDRS III评分之间存在轻微相关性。未发现PD患者R*信号值与NMSS和MMSE量表之间存在相关性。
感兴趣区域的铁浓度可能代表PD运动症状的严重程度，其是否与非运动症状相关仍有待进一步研究。ESWAN在确定脑内铁沉积和实现PD的敏感诊断方面具有特殊优势，尽管仍需进一步研究。
