Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam-si, 13620, Republic of Korea.
Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam-si, 13620, Republic of Korea.
Eur J Radiol. 2021 Jan;134:109398. doi: 10.1016/j.ejrad.2020.109398. Epub 2020 Nov 11.
To determine whether susceptibility map-weighted imaging (SMWI) was superior to conventional susceptibility-weighted imaging (SWI) in the diagnosis of Parkinson's disease (PD) and in its correlation with I-2bcarbomethoxy-3b-(4-iodophenyl)-N-(3-fluoropropyl)-nortropane single photon emission computerized tomography (I-FP-CIT SPECT).
Between May 2017 and February 2018, 125 consecutive patients diagnosed with idiopathic PD, vascular pseudoparkinsonism, essential tremor, or drug-induced parkinsonism and who underwent I-FP-CIT SPECT imaging and 3 T SWI on the same day or within 3 months were included in this retrospective study. In all patients, SMWI images were generated from SWI images. On both MRIs, two neuroradiologists independently evaluated the status of nigral hyperintensity on each side of substantia nigra. Inter-observer agreements for the nigral hyperintensity were tested. Using consensus reading, concordance between SWI, SMWI, and I-FP-CIT SPECT were evaluated, and the diagnostic performance between SWI and SMWI for PD was compared.
Inter-observer agreement for the nigral hyperintensity was higher for SMWI (right, κ = 0.919; left, κ = 0.984) than for SWI (right, κ = 0.918; left, κ = 0.902). SMWI (right 67.2 %, left 68.0 %) showed a higher concordance rate with the results of I-FP-CIT SPECT than SWI (right 60.0 %, left 59.2 %). SMWI (area under curve [AUC], 0.791) provided significantly higher diagnostic performance for PD than SWI (AUC, 0.720; P = 0.0005).
SMWI may be a superior assessment tool for nigral hyperintensity than SWI and may be an improved diagnostic imaging modality for patients with suspected PD.
确定磁化传递对比加权成像（SMWI）在帕金森病（PD）的诊断中是否优于传统磁化传递对比加权成像（SWI），以及与 I-2b 碳甲氧基-3b-（4-碘苯基）-N-（3-氟丙基）-去甲托烷单光子发射计算机断层扫描（I-FP-CIT SPECT）的相关性。
本回顾性研究纳入了 2017 年 5 月至 2018 年 2 月间连续 125 例因特发性 PD、血管性假性帕金森病、特发性震颤或药物诱导性帕金森病而接受 I-FP-CIT SPECT 成像和 3T SWI 的患者，所有患者的 SWI 图像均来自于 SMWI 图像。在这两种 MRI 上，两位神经放射科医生独立评估了每个黑质侧的黑质高信号状态。测试了黑质高信号的观察者间一致性。采用共识阅读法，评估了 SWI、SMWI 和 I-FP-CIT SPECT 之间的一致性，并比较了 SWI 和 SMWI 对 PD 的诊断性能。
SMWI 对黑质高信号的观察者间一致性（右侧，κ=0.919；左侧，κ=0.984）高于 SWI（右侧，κ=0.918；左侧，κ=0.902）。SMWI（右侧 67.2%，左侧 68.0%）与 I-FP-CIT SPECT 结果的一致性率高于 SWI（右侧 60.0%，左侧 59.2%）。SMWI（曲线下面积[AUC]，0.791）对 PD 的诊断性能明显优于 SWI（AUC，0.720；P=0.0005）。
与 SWI 相比，SMWI 可能是一种更好的黑质高信号评估工具，并且可能是疑似 PD 患者的一种改进的诊断成像方式。
