Yamashita Koji, Hiwatashi Akio, Togao Osamu, Kikuchi Kazufumi, Yamaguchi Hiroo, Suzuki Yuriko, Kamei Ryotaro, Yamasaki Ryo, Kira Jun-Ichi, Honda Hiroshi
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Neurology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Magn Reson Imaging. 2017 Jun;45(6):1821-1826. doi: 10.1002/jmri.25489. Epub 2016 Oct 3.
To evaluate cerebral blood flow (CBF) laterality derived from arterial spin labeling (ASL) in early-stage Parkinson's disease (PD) patients compared with those with advanced stages.
Thirty-eight patients with PD (21 patients in early stages, 17 patients in advanced stages) were retrospectively studied. The CBF maps derived from 3T ASL data were co-registered to the corresponding 3DT1WI using SPM 12 software. Caudate nucleus (CN), putamen (PT), globus pallidus (GP), and thalamus (TH) were manually traced on the representative axial slices of 3DT1WI. CBF of the CN, PT, GP, and TH was measured using corresponding pixels on the co-registered CBF maps. A laterality index (LI) was calculated as the ratio of the contralateral CBF to primary affected side CBF. Each LI was compared between early and advanced stages of PD using the Mann-Whitney U-test. The LIs were also compared between each stage of PD.
In the CN, the LIs were significantly higher in early stages (mean LI ± SD, 95% confidence interval = 1.06 ± 0.14, 1.00-1.13) than in advanced stages (0.94 ± 0.14, 0.87-1.01; P < 0.05). We also observed a tendency toward decreased LIs with disease severity (1.10 ± 0.14, 0.99-1.21 for Hoehn and Yahr stage I; 1.04 ± 0.14, 0.92-1.12 for stage II; 0.96 ± 0.11, 0.89-1.10 for stage III; 0.93 ± 0.17, 0.81-1.05 for stage IV).
The evaluation of CBF laterality pattern in the CN using ASL may be useful for assessing the disease severity of PD patients.
3 J. MAGN. RESON. IMAGING 2017;45:1821-1826.
评估早期帕金森病（PD）患者与晚期患者相比，动脉自旋标记（ASL）衍生的脑血流量（CBF）的偏侧性。
回顾性研究38例PD患者（21例早期患者，17例晚期患者）。使用SPM 12软件将源自3T ASL数据的CBF图与相应的3DT1WI进行配准。在3DT1WI的代表性轴位切片上手动描绘尾状核（CN）、壳核（PT）、苍白球（GP）和丘脑（TH）。使用配准后的CBF图上的相应像素测量CN、PT、GP和TH的CBF。计算偏侧性指数（LI），即对侧CBF与主要受累侧CBF的比值。使用Mann-Whitney U检验比较PD早期和晚期的每个LI。还比较了PD各阶段之间的LI。
在CN中，早期的LI显著高于晚期（平均LI±标准差，95%置信区间=1.06±0.14，1.00-1.13）（0.94±0.14，0.87-1.01；P<0.05）。我们还观察到随着疾病严重程度LI有降低的趋势（Hoehn和Yahr I期为1.10±0.14，0.99-1.21；II期为1.04±0.14，0.92-1.12；III期为0.96±0.11，0.89-1.10；IV期为0.93±0.17，0.81-1.05）。
使用ASL评估CN中的CBF偏侧性模式可能有助于评估PD患者的疾病严重程度。
3 J.MAGN.RESON.IMAGING 2017；45：1821-1826。
