Kim Eung Yeop, Sung Young Hee, Shin Hyeong Geol, Noh Young, Nam Yoonho, Lee Jongho
Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea.
Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea.
J Clin Neurol. 2018 Jan;14(1):90-97. doi: 10.3988/jcn.2018.14.1.90.
To test whether nigrosome-1 imaging using high-resolution quantitative susceptibility mapping (QSM) combined with histogram analysis can improve the diagnostic accuracy in early-stage idiopathic Parkinson's disease (IPD) patients.
Three-dimensional multiecho gradient-recalled echo images (0.5×0.5×1.0 mm³) were obtained at 3 T for QSM in 38 patients with IPD and 25 healthy subjects. To segment the substantia nigra (SN), regions of interest (ROIs) were semiautomatically drawn at the location below the red nucleus, and the normal-appearing nigrosome-1 was determined by manual correction. QSM histograms were obtained within the ROI. The segmented SN regions on the right and left that had higher mean susceptibility values and fewer voxels with susceptibility values lower than 60, 65, 70, 75, and 80 ppb were chosen for comparisons between the IPD patients and healthy subjects. These results were compared with those of the visual assessments of nigrosome-1 in susceptibility map-weighted imaging (SMWI) by analyzing receiver operating characteristics curves.
The proportion of voxels with susceptibility values lower than 70 ppb showed the best diagnostic performance, with its value differing significantly between the IPD patients (median=0, interquartile range=0-0.23) and healthy subjects (median=10.67, interquartile range=5.98-21.57) (p<0.0001). The number of voxels with susceptibility values lower than 60, 65, 70, 75, and 80 ppb showed worse diagnostic performances but were still significantly better than that of the mean susceptibility value (p=0.0249, 0.0192, 0.0183, 0.0191, and 0.0186, respectively), which also differed significantly between the two groups: 125.81±16.27 ppb (mean±standard deviation) in IPD versus 98.41±11.70 ppb in healthy subjects (p<0.0001). Additionally, using the proportion of voxels with susceptibility values lower than 70 ppb provided significantly better diagnostic performance than did visual assessments of SMWI (p=0.0143).
High-spatial-resolution QSM combined with histogram analysis at 3 T can improve the diagnostic accuracy of early-stage IPD.
测试使用高分辨率定量磁化率成像（QSM）结合直方图分析的黑质1成像是否能提高早期特发性帕金森病（IPD）患者的诊断准确性。
在3T条件下，对38例IPD患者和25名健康受试者进行三维多回波梯度回波成像（0.5×0.5×1.0mm³）以获取QSM。为分割黑质（SN），在红核下方位置半自动绘制感兴趣区域（ROI），并通过手动校正确定外观正常的黑质1。在ROI内获取QSM直方图。选择左右两侧分割的SN区域，其平均磁化率值较高且磁化率值低于60、65、70、75和80ppb的体素较少，用于IPD患者与健康受试者之间的比较。通过分析受试者工作特征曲线，将这些结果与在磁化率图加权成像（SMWI）中对黑质1的视觉评估结果进行比较。
磁化率值低于70ppb的体素比例显示出最佳诊断性能，其值在IPD患者（中位数=0，四分位间距=0 - 0.23）和健康受试者（中位数=10.67，四分位间距=5.98 - 21.57）之间存在显著差异（p<0.0001）。磁化率值低于60、65、70、75和80ppb的体素数量显示出较差的诊断性能，但仍显著优于平均磁化率值（p分别为0.0249、0.0192、0.0183、0.0191和0.0186），两组之间也存在显著差异：IPD患者为125.81±16.27ppb（均值±标准差），健康受试者为98.41±11.70ppb（p<0.0001）。此外，使用磁化率值低于70ppb的体素比例提供的诊断性能明显优于SMWI的视觉评估（p=0.0143）。
3T条件下的高空间分辨率QSM结合直方图分析可提高早期IPD的诊断准确性。
