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目的 利用磁共振磁敏感加权成像(MR SWI)技术评价黑质小体-1的影像学特征,并探究其与帕金森病患者病程、病情之间的相关性.方法 收集2014年9月至2016年4月于苏州大学附属第二医院经神经内科医师确诊的32例帕金森病患者及年龄、性别与之匹配的健康对照者20名.记录帕金森病患者的病程(月)、帕金森病统一评定量表第三部分(UPDRS-Ⅲ)评分、改良Hoehn-Yahr(H-Y)分级等临床资料.对所有受试者行颅脑MR SWI检查,然后由两名医师双盲评价受试者黑质小体-1在SWI图像上的影像特征,分析黑质小体-1的影像特征与临床资料的相关性.结果 在帕金森病患者中,有21例MR SWI图像显示双侧“缺失燕尾征”,5例显示双侧“模糊燕尾征”,5例显示一侧“缺失燕尾征”对侧“模糊燕尾征”,1例显示双侧“清晰燕尾征”.“缺失燕尾征”患者的病程[56(54)个月]显著长于“未完全缺失燕尾征”患者[18(18)个月,U=-2.47,P=0.01];“缺失燕尾征”患者的改良H-Y分级[2.0(0.5)级]显著高于“未完全缺失燕尾征”患者[1.5(0.5)级,U=-2.21,P=0.03)];“缺失燕尾征”和“未完全缺失燕尾征”患者的UPDRS-Ⅲ评分[(24(8)、13(14)分]差异有统计学意义(U=-2.91,P=0.01),但是两组患者的汉密尔顿抑郁量表评分[5(2)、5(7)分,U=-0.10,P=0.94]及汉密尔顿焦虑量表评分[3.0(2.5),3.0(3.0),U=-0.02,P=1.00)差异均无统计学意义.结论 MR SWI图像上黑质小体-1的影像学特征与帕金森病患者的病情及运动症状的严重程度密切相关,可以用来反映帕金森病患者病情的严重程度.

Objective To evaluate the imaging features of nigrosome-1 in Parkinson's disease (PD) with a 3 T scanner by susceptibility weighted imaging (SWI),and to explore its clinical relevance.Methods Thirty-two patients with primary PD diagnosed by neurologists were collected.Healthy controls matched to their age and gender were recruited during the same period (n=20).All subjects underwent routine brain magnetic resonance imaging (MRI) and sensitive weighted imaging (SWI).The SWI images of the subjects were evaluated to evaluate nigrosome-1 by blinded investigators.Then,the correlation between imaging features and clinical data was analyzed.Results In the PD group,21 cases of bilateral "absent swallow-tail sign",five cases of bilateral "indecisive swallow-tail sign",five cases of "absent swallow-tail sign" on one side and "indecisive swallow-tail sign" on the other side,and one case of bilateral "clear swallow-tail sign" were found.The course of the "absent swallow-tail sign" group (56 (54) months) was significantly longer than the "non-absent swallow-tail sign" group (18 (18) months;U=-2.47,P=0.01).The Hoehn-Yahr stage was significantly higher in the "absent swallow-tail sign" group (2.0 (0.5)) than in the "non-absent swallow-tail sign" group (1.5 (0.5),U=-2.21,P=0.03).There was also a statistically significant difference in the Unified Parkinson's Disease Rating Scale score (24 (8),13 (14)) between the two groups (U=-2.91,P=0.01).However,there were no statistically significant differences between the two groups in the Hamilton Depression Scale score (5 (2) vs 5 (7),U=-0.10,P=0.94) and the Hamilton Anxiety Scale score (3.0 (2.5) vs 3.0 (3.0),U=-0.02,P=1.00).Conclusion The images of nigrosome-1 by SWI are closely related to the severity of the condition and motor symptoms of patients with PD,which can reflect the severity of the disease.