基于体素分析的动脉自旋标记技术在帕金森病脑血流量中的应用

摘要

目的 应用动脉自旋标记(ASL)技术寻找PD早期诊断和病程监测的影像学生物标记.方法 将2014年7月～2017年5月就诊于我院的23例确诊为PD的患者行头颅MRI及ASL检查,其中早期13例,中晚期10例;应用基于体素分析(VBA)技术观察不同分期PD患者局部脑血流量(rCBF)特征;并用三维连续动脉自旋标记技术分析不同分期PD组以及正常对照组的全脑平均脑血流量特征.结果 方差分析显示早期、中晚期PD组和正常对照组的全脑平均脑血流量差异无统计学意义(P=0.30).VBA分析发现,静息状态下,与正常对照相比,早期PD组的rCBF减低区主要分布于右侧枕上回和右侧额上回(P<0.001),中晚期PD组的rCBF减低区主要分布于左侧中央前回、左侧中央后回(P<0.001);中晚期与早期PD组相比,表现为右侧中脑黑质、双侧胼胝体等皮层下rCBF减低(P<0.001).结论 应用VBA的ASL技术发现,PD组与正常对照组相比rCBF发生改变,并且中晚期与早期患者相比rCBF也有不同,提示此技术能够为找寻PD早期诊断和病程追踪的影像学生物标记提供帮助.%Objective To explore the imaging biomarker for early diagnosis and disease course monitoring of Parkinson disease (PD) in arterial spin labeling (ASL) technique. Methods Between July, 2014 and May, 2017, 23 patients with PD underwent magnetic resonance imaging (MRI) and ASL examinations in our hospital, including 13 in the early stage and 10 in advanced stages. Voxel-based analysis (VBA) was used to observe the regional cerebral blood flow (rCBF) characteristics in PD patients in different stages and three-dimensional continuous arterial spin labeling (3D CASL) was used to analyze the mean cerebral blood flow (mCBF). Results No significant difference was found in mCBF among PD patients in the early stage, patients in advanced stages and normal control subjects (P=0.30). Compared with the normal control group, the patients with early-stage PD had decreased rCBF in resting state mainly in the right superior occipital gyrus and the right superior frontal gyrus as revealed by VBA (P<0.001);the patients with advanced PD showed decreased rCBF mainly in the left precentral gyrus and the postcentral gyrus (P<0.001). The patients with advanced PD exhibited lowered rCBF in the right substantia nigra and the bilateral corpus callosum as compared with the early-stage patients (P<0.001). Conclusions VBA of ASL reveals rCBF alterations in association with the disease progression in PD patients, suggesting that this technique might provide assistance in identification of potential markers for early PD diagnosis and for monitoring the disease course.