Pecs Diagnostic Centre, Pecs, Hungary.
Department of Neurology, Medical School, University of Pecs, Pecs, Hungary.
Sci Rep. 2021 Jan 13;11(1):1179. doi: 10.1038/s41598-020-80836-7.
The absence of nigral hyperintensity is a promising MR marker for Parkinson's disease (PD), but its small size imposes limitations on its routine use. Our aim was to compare Multi Echo Data Image Combination (MEDIC), segmented echo-planar imaging (EPISEG) and fluid-attenuated inversion recovery (FLAIR) sequences, as well as both magnitude (MAG) and susceptibility-weighted imaging (SWI) reconstructions of single-echo gradient echo for nigral hyperintensity imaging. Twenty-five healthy and twenty PD subjects were included. Sensitivity to motion artefacts, confidence of the radiologist in interpretation, rate of nondiagnostic scans and diagnostic accuracy were assessed. EPISEG was less motion-sensitive than MEDIC, MAG, and SWI, while FLAIR was less motion-sensitive than MAG and SWI. The reviewers were more confident when using EPISEG compared to any other techniques and MEDIC was superior to FLAIR. The proportions of nondiagnostic scans were lower for EPISEG than for other sequences. The best diagnostic performance was achieved for EPISEG (sensitivity = 65%, specificity = 96%). Using EPISEG, the absence of nigral hyperintensity in PD was associated with higher Hoehn-Yahr stage and MDS-UPDRS II + III. Nigral hyperintensity may be intact at the very early stages of PD. The promising properties of EPISEG may help the transfer of nigral hyperintensity imaging into daily clinical practice.
黑质高信号的缺失是帕金森病（PD）有前景的磁共振成像（MRI）标志物，但由于其体积小，限制了其常规应用。我们的目的是比较多回波数据图像组合（MEDIC）、分段回波平面成像（EPISEG）和液体衰减反转恢复（FLAIR）序列，以及单回波梯度回波的幅度（MAG）和磁化率加权成像（SWI）重建，以进行黑质高信号成像。纳入了 25 名健康人和 25 名 PD 患者。评估了对运动伪影的敏感性、放射科医生解释的信心、无诊断性扫描的比例和诊断准确性。EPISEG 比 MEDIC、MAG 和 SWI 对运动伪影的敏感性更小，而 FLAIR 比 MAG 和 SWI 对运动伪影的敏感性更小。与其他任何技术相比，EPISEG 的观察者更有信心，而 MEDIC 则优于 FLAIR。与其他序列相比，EPISEG 的无诊断性扫描比例更低。EPISEG 的诊断性能最佳（敏感性=65%，特异性=96%）。在 PD 中，EPISEG 未见黑质高信号与较高的 Hoehn-Yahr 分期和 MDS-UPDRS II+III 相关。黑质高信号可能在 PD 的早期阶段是完整的。EPISEG 的良好特性可能有助于将黑质高信号成像转移到日常临床实践中。
