From the Department of Neuroradiology, Brain MRI 3T Research Center (P.V., G.G., A.F., C.A.M.G.W.), Brain Connectivity Centre (F.P.), and Parkinson's Disease and Movement Disorders Unit (B.M., R.Z., C.P.), IRCCS Mondino Foundation, Pavia, Italy; Departments of Neurology (M.I.P.) and Brain and Behavioural Sciences (F.P., C.A.M.G.W.), University of Pavia, Pavia, Italy; Neuroradiology Unit, San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy (N.A.); Department of Radiology, Acqui Terme Hospital, Acqui Terme, Italy (P.F.); and NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, London, England (C.A.M.G.W.).
Radiology. 2020 Aug;296(2):401-410. doi: 10.1148/radiol.2020191235. Epub 2020 Jun 16.
Background Magnetization transfer-prepared T1-weighted MRI can depict a hyperintense subregion of the substantia nigra involved in the degeneration process of Parkinson disease. Purpose To evaluate quantitative measurement of substantia nigra volume by using MRI to support clinical diagnosis and staging of Parkinson disease. Materials and Methods In this prospective study, a high-spatial-resolution magnetization transfer-prepared T1-weighted volumetric sequence was performed with a 3-T MRI machine between January 2014 and October 2015 for participants with de novo Parkinson disease, advanced Parkinson disease, and healthy control participants. A reproducible semiautomatic quantification analysis method that entailed mesencephalic intensity as an internal reference was used for hyperintense substantia nigra volumetry normalized to intracranial volume. A general linear model with age and sex as covariates was used to compare the three groups. Results Eighty participants were evaluated: 20 healthy control participants (mean age ± standard deviation, 56 years ± 11; 11 women), 29 participants with de novo Parkinson disease (64 years ± 10; 19 men), and 31 participants with advanced Parkinson disease (60 years ± 9; 16 women). Volumetric measurement of hyperintense substantia nigra from magnetization transfer-prepared T1-weighted MRI helped differentiate healthy control participants from participants with advanced Parkinson disease (mean difference for ipsilateral side, 64 mm ± 14, < .001; mean difference for contralateral side, 109 mm ± 14, < .001) and helped distinguish healthy control participants from participants with de novo Parkinson disease (mean difference for ipsilateral side, 45 mm ± 15, < .01; mean difference for contralateral side, 66 mm ± 15, < .001) and participants with de novo Parkinson disease from those with advanced Parkinson disease (mean difference for ipsilateral side, 20 mm ± 13, = .40; mean difference for contralateral side, 43 mm ± 13, = .004). Conclusion Magnetization transfer-prepared T1-weighted MRI volumetry of the substantia nigra helped differentiate the stages of Parkinson disease. © RSNA, 2020
背景 磁化传递准备 T1 加权 MRI 可以描绘出帕金森病退化过程中黑质的一个高信号亚区。目的 利用 MRI 定量测量黑质体积，以支持帕金森病的临床诊断和分期。材料与方法 本前瞻性研究于 2014 年 1 月至 2015 年 10 月期间在 3.0T MRI 机上对新发帕金森病、晚期帕金森病和健康对照组参与者进行了高空间分辨率磁化传递准备 T1 加权容积序列检查。采用一种可重复性半自动化定量分析方法，以中脑强度为内部参考，对黑质进行高信号容积测量，并进行颅内容积标准化。采用包含年龄和性别作为协变量的广义线性模型对三组进行比较。结果 共评估了 80 名参与者：20 名健康对照组参与者（平均年龄 ± 标准差，56 岁 ± 11；11 名女性），29 名新发帕金森病患者（64 岁 ± 10；19 名男性），31 名晚期帕金森病患者（60 岁 ± 9；16 名女性）。磁化传递准备 T1 加权 MRI 测量高信号黑质容积有助于区分健康对照组与晚期帕金森病患者（患侧侧差异，64mm ± 14，<.001；对侧侧差异，109mm ± 14，<.001），并有助于区分健康对照组与新发帕金森病患者（患侧侧差异，45mm ± 15，<.01；对侧侧差异，66mm ± 15，<.001），以及新发帕金森病患者与晚期帕金森病患者（患侧侧差异，20mm ± 13，=.40；对侧侧差异，43mm ± 13，=.004）。结论 黑质磁化传递准备 T1 加权 MRI 容积有助于区分帕金森病的阶段。 © 2020 RSNA
