基于 3T MRI-SWI 的晚期帕金森病患者丘脑底核和红核的容积分析。
3T MRI-SWI based volumetric analysis of the subthalamic and red nuclei in advanced Parkinson's disease.
机构信息
Department of Neurosurgery, Nizam's Institute of Medical Sciences, Hyderabad, India.
Department of Neurosurgery, Nizam's Institute of Medical Sciences, Hyderabad, India -
出版信息
J Neurosurg Sci. 2023 Feb;67(1):108-112. doi: 10.23736/S0390-5616.20.04935-8. Epub 2020 May 13.
BACKGROUND
Parkinson's disease (PD) is a neurodegenerative disease mainly involving the dopaminergic neurons of the substantia nigra. The subthalamic nucleus (STN) also plays an important role in the disease process and now is an important target for the surgical management of the disease. However, not much is known about its morphology as the disease progresses. The aim of this study was to evaluate the volume of STN and red nucleus (RN) on 3T MRI SWI and its possible correlation with the disease in patients with advanced Parkinson's disease.
METHODS
A total of 30 patients were enrolled. They were evaluated by analysis of symptomatology, UPDRS III, MOCA. Radiological evaluation included volumetric SWI images in 3T MRI. The volumes of the STN and RN were measured on SWI coronal images.
RESULTS
There were 24 (80%) males and 6 (20%) females. The mean volumes of STN and RN were 118.66 mm (80-170 mm) and 379.66 mm (270-500 mm). There was no significant difference between right and left STN volumes and RN volumes. There was a significant positive correlation between the disease duration and RN volumes (P=0.015) and STN volumes (in 6-13 years) (P=0.001). STN and RN volumes were negatively correlated with MOCA scores in males (P=0.008 and P=0.017), with no such correlation in females. In late-onset PD, there was a significant positive correlation between RN volume and UPDRS OFF and ON scores (P=0.028 and P=0.03).
CONCLUSIONS
STN volumes show a positive trend as the disease duration increases and cognition declines. RN volumes also increase as the disease progresses.
背景
帕金森病（PD）是一种主要涉及黑质多巴胺能神经元的神经退行性疾病。丘脑底核（STN）在疾病过程中也起着重要作用，现在是疾病手术治疗的重要靶点。然而，随着疾病的进展，对于其形态学变化我们知之甚少。本研究旨在评估 3T MRI SWI 上 STN 和红核（RN）的体积及其与晚期帕金森病患者疾病的可能相关性。
方法
共纳入 30 例患者。通过分析症状、UPDRS III、MOCA 对其进行评估。影像学评估包括 3T MRI 容积 SWI 图像。在 SWI 冠状图像上测量 STN 和 RN 的体积。
结果
男性 24 例（80%），女性 6 例（20%）。STN 和 RN 的平均体积分别为 118.66mm（80-170mm）和 379.66mm（270-500mm）。左右 STN 体积和 RN 体积无显著差异。疾病持续时间与 RN 体积（P=0.015）和 STN 体积（6-13 年）（P=0.001）呈显著正相关。在男性中，STN 和 RN 体积与 MOCA 评分呈负相关（P=0.008 和 P=0.017），而在女性中无相关性。在晚发性 PD 中，RN 体积与 UPDRS OFF 和 ON 评分呈显著正相关（P=0.028 和 P=0.03）。
结论
随着疾病持续时间的增加和认知能力的下降，STN 体积呈正趋势。随着疾病的进展，RN 体积也会增加。
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