目的 利用定量磁敏感成像(QSM)技术测定帕金森病(PD)脑灰质核团的铁沉积含量特征及其与临床病情的相关性,探讨其在帕金森病发病机制中的作用。方法 选择2023-05至2024-05北京市航天中心医院收治的PD患者,同时入组年龄与性别相似的健康对照(NC)组,PD组患者和NC组进行核磁扫描,经过Matlab后处理软件得到最终QSM磁敏感值(MSV)参数图。测量尾状核头、豆状核、红核、黑质及齿状核的MSV。PD组根据Hoehn-Yahr分期分为轻度疾病组(Hoehn-Yahr分期≤2.5) 和中-重度疾病组 (Hoehn-Yahr分期≥3.0),根据统一帕金森病评分量表第3部分(UPDRS-Ⅲ)分为低分组及高分组,比较不同组别之间核团MSV值的差异及其与临床病情间的相关性。结果 PD不同病情程度组别、不同评分组别与NC组间比较,多个核团MSV值差异有统计学意义,其中黑质和齿状核MSV值较高,且各组间差异均有统计学意义(P＜0.05),PD中-重度疾病组黑质与齿状核MSV值与UPDRS-III评分存在相关性(P＜0.05)。结论 QSM可反映PD患者脑灰质核团的铁沉积含量,成为评价PD发生发展的重要影像学标志物。黑质与齿状核铁沉积含量最能反映PD病情尤其是运动症状的严重程度。

Objective To determine iron deposition in gray matter nuclei of Parkinson's disease (PD) by quantitative magnetic sensitivity imaging (QSM) and its correlation with clinical conditions, and to explore its role in the pathogenesis of PD. Methods PD patients admitted to Beijing Aerospace Central Hospital from May 2023 to May 2024 were enrolled into PD group and normal control (NC) group with similar age and sex were chosen. PD patients and NC group were subjected to magnetic resonance imaging, and the final QSM magnetic sensitive value (MSV) parameter graph was obtained by Matlab post-processing software. The MSV of caudate nucleus, lenticular nucleus, red nucleus, substantia nigra and dentate nucleus were measured. PD group was divided into mild disease group (Hoehn-Yahr stage≤2.5) and moderate-severe disease group (Hoehn-Yahr stage≥3.0) according to Hoehn-Yahr stage. According to part 3 of unified Parkinson's disease rating scale (UPDRS-Ⅲ), the patients were divided into low and high score groups. The differences of nuclear MSV values between different groups and their correlation with clinical conditions were compared. Results There were statistically significant differences in MSV values of multiple nuclear masses between PD groups, PD scoring groups and NC group (P<0.05). The MSV values of substantia nigra and dentate nucleus were higher, and the differences between the groups were statistically significant (P<0.05). There was correlation between the MSV values of substantia nigra and dentate nucleus and UPDRS-Ⅲ score in PD moderate-severe disease group (P<0.05). Conclusions QSM can reflect the content of iron deposition in gray matter nuclei of PD patients, and become an important imaging biomarker to evaluate the occurrence and development of PD. The content of iron deposition in substantia nigra and dentate nucleus can best reflect the severity of PD, especially the motor symptoms.