Fushimi Yasutaka, Ghassaban Kiarash, Sethi Sean K, Nakajima Satoshi, Okuchi Sachi, Sakata Akihiko, Yamamoto Takayuki, Otani Sayo, Ikeda Satoshi, Terada Yuta, Shima Atsushi, Sawamoto Nobukatsu, Nakamoto Yuji
Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
SpinTech MRI., Bingham Farms, MI, USA.
Jpn J Radiol. 2025 Aug 18. doi: 10.1007/s11604-025-01858-7.
To differentiate between Parkinson's Disease (PD) and healthy controls by using integrated analysis of PD-specific MR findings including deformation of the substantia nigra pars compacta (SNpc), signal loss in neuromelanin (NM) sensitive MRI, and iron deposition in the deep gray matter (DGM) structures.
Patients with PD and healthy controls were recruited between August 2022 and December 2023. All subjects underwent 3 T MRI including a magnetization transfer contrast (MTC) and a double flip angle multi-echo protocol as part of Strategically Acquired Gradient Echo (STAGE). The data analysis included detecting the presence of Nigrosome-1 (N1) sign in the SNpc, signal intensity and volume of NM content and iron quantification through quantitative susceptibility mapping (QSM) in DGMs. The 3D regions of interest were manually demarcated on QSM maps. Mean susceptibility values from global analysis (whole structure) as well as regional high iron analysis (age-based threshold) were extracted for each individual structure. Univariate and multivariate analyses were performed using these parameters.
Nineteen patients with PD (68.0 ± 8.0 years, 10 males, Hoehn and Yahr scale 1 (n = 1), 2 (n = 13), 3 (n = 4), 4 (n = 1)) and 21 healthy controls (68.3 ± 8.6 years, 12 males) were enrolled. Discriminating PD from controls was successful using each method: N1 sign (P < 0.001), NM volume (P < 0.001), susceptibility values of global analysis (caudate, P < 0.001; putamen, P < 0.001; pulvinar, P = 0.006), regional analysis (putamen, P < 0.001; pulvinar, P = 0.009, thalamus, P = 0.008). Stepwise logistic regression analyses were performed, and the best model was created using N1 sign, NM volume, regional analysis (putamen, red nucleus and thalamus) (area under the curve of 0.99).
Integrated analysis of PD specific MR findings including N1 sign, NM volume, and iron content in the DGM structures robustly discriminates between PD and healthy controls.
通过对帕金森病（PD）特异性磁共振成像（MRI）表现进行综合分析，包括黑质致密部（SNpc）变形、神经黑色素（NM）敏感MRI中的信号缺失以及深部灰质（DGM）结构中的铁沉积，以区分帕金森病（PD）和健康对照。
在2022年8月至2023年12月期间招募了PD患者和健康对照。所有受试者均接受了3T MRI检查，包括磁化传递对比（MTC）和作为策略性采集梯度回波（STAGE）一部分的双翻转角多回波协议。数据分析包括检测SNpc中黑质小体-1（N1）征的存在、NM含量的信号强度和体积，以及通过DGMs中的定量磁化率映射（QSM）进行铁定量分析。在QSM图上手动划定感兴趣的三维区域。提取每个个体结构的全局分析（整个结构）以及区域高铁分析（基于年龄的阈值）的平均磁化率值。使用这些参数进行单变量和多变量分析。
纳入了19例PD患者（68.0±8.0岁，男性10例，Hoehn和Yahr分级1级（n = 1）、2级（n = 13）、3级（n = 4）、4级（n = 1））和21例健康对照（68.3±8.6岁，男性12例）。使用每种方法都成功地将PD与对照区分开来：N1征（P < 0.001）、NM体积（P < 0.001）、全局分析的磁化率值（尾状核，P < 0.001；壳核，P < 0.001；丘脑枕，P = 0.006）、区域分析（壳核，P < 0.001；丘脑枕，P = 0.009，丘脑，P = 0.008）。进行了逐步逻辑回归分析，并使用N1征、NM体积、区域分析（壳核、红核和丘脑）创建了最佳模型（曲线下面积为0.99）。
对包括N1征、NM体积和DGM结构中铁含量在内的PD特异性MRI表现进行综合分析，能够有力地区分PD和健康对照。
