Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, 210006, Nanjing, Jiangsu Province, China.
BMC Med Imaging. 2024 Mar 5;24(1):58. doi: 10.1186/s12880-024-01229-0.
MULTIPLEX is a single-scan three-dimensional multi-parametric MRI technique that provides 1 mm isotropic T1-, T2*-, proton density- and susceptibility-weighted images and the corresponding quantitative maps. This study aimed to investigate its feasibility of clinical application in Parkinson's disease (PD).
27 PD patients and 23 healthy control (HC) were recruited and underwent a MULTIPLEX scanning. All image reconstruction and processing were automatically performed with in-house C + + programs on the Automatic Differentiation using Expression Template platform. According to the HybraPD atlas consisting of 12 human brain subcortical nuclei, the region-of-interest (ROI) based analysis was conducted to extract quantitative parameters, then identify PD-related abnormalities from the T1, T2* and proton density maps and quantitative susceptibility mapping (QSM), by comparing patients and HCs.
The ROI-based analysis revealed significantly decreased mean T1 values in substantia nigra pars compacta and habenular nuclei, mean T2* value in subthalamic nucleus and increased mean QSM value in subthalamic nucleus in PD patients, compared to HCs (all p values < 0.05 after FDR correction). The receiver operating characteristic analysis showed all these four quantitative parameters significantly contributed to PD diagnosis (all p values < 0.01 after FDR correction). Furthermore, the two quantitative parameters in subthalamic nucleus showed hemicerebral differences in regard to the clinically dominant side among PD patients.
MULTIPLEX might be feasible for clinical application to assist in PD diagnosis and provide possible pathological information of PD patients' subcortical nucleus and dopaminergic midbrain regions.
MULTIPLEX 是一种单扫描三维多参数 MRI 技术,可提供 1mm 各向同性 T1、T2*、质子密度和磁化率加权图像及其对应的定量图。本研究旨在探讨其在帕金森病(PD)临床应用中的可行性。
共招募 27 例 PD 患者和 23 名健康对照者(HC)进行 MULTIPLEX 扫描。所有图像重建和处理均在自动微分使用表达式模板平台上的内部 C++程序自动完成。根据包含 12 个人脑皮质下核的 HybraPD 图谱,通过比较患者和 HC,在 T1、T2* 和质子密度图及定量磁化率图(QSM)上进行基于感兴趣区(ROI)的分析,以提取定量参数,并识别 PD 相关异常。
基于 ROI 的分析显示,与 HC 相比,PD 患者的黑质致密部和缰核的平均 T1 值、丘脑底核的平均 T2* 值和丘脑底核的平均 QSM 值均显著降低(所有 FDR 校正后 p 值均<0.05)。ROC 分析显示,这四个定量参数均对 PD 诊断有显著贡献(所有 FDR 校正后 p 值均<0.01)。此外,PD 患者丘脑底核的两个定量参数在与临床优势侧有关的半脑间存在差异。
MULTIPLEX 可能适用于临床应用,以辅助 PD 诊断,并为 PD 患者皮质下核和多巴胺能中脑区域提供可能的病理信息。