磁共振成像在评估帕金森病嗅觉障碍中的应用研究

发布时间：2018-05-14 13:29

本文选题：帕金森病 + 嗅觉障碍　；参考：《苏州大学》2014年硕士论文

【摘要】：第一部分高分辨磁共振成像在帕金森病嗅球体积及嗅沟深度测量中的应用目的：通过对嗅球及嗅沟进行高分辨磁共振成像，探讨磁共振成像测量嗅球体积及嗅沟深度对帕金森病嗅觉障碍评估的临床应用价值。方法：采用Philips Achieva1.5T超导型全身磁共振成像仪和16通道头-颈联合线圈，对40例存在嗅觉障碍的PD患者和30例正常对照组进行高分辨磁共振冠状位成像，分别测量嗅球体积及嗅沟深度，并进行统计学分析。PD组与对照组之间嗅球体积及嗅沟深度比较采用两独立样本t检验，，PD组嗅球体积与病程的关系采用控制年龄的偏相关性分析。结果：PD组与对照组嗅球体积分别为10.38±4.66mm3、18.68±10.84mm3，两者比较差异有统计学意义（t=6.135, P 0.001）；PD组与对照组嗅沟深度分别为10.97±1.826mm、11.55±1.89mm，两者比较差异无统计学意义（t=1.296, P=0.199）。PD组H-Y I级与H-Y II级嗅球体积（分别为11.48±6.04mm3、9.83±3.12mm3; t=1.131, P=0.265）及嗅沟深度（分别为11.04±2.15mm、10.92±1.59mm; t=0.224, P=0.824）分别比较差异均无统计学意义。PD组嗅球体积（左侧嗅球、右侧嗅球及两侧嗅球总体积）与病程均无明确相关性（分别为r=-0.141, P=0.393; r=-0.130, P=0.429; r=-0.139,P=0.400）。结论：帕金森病患者嗅球体积明显减小，高分辨磁共振成像对嗅球体积的定量分析有助于帕金森病嗅觉障碍的评估。第二部分磁共振双回波序列T2值评估帕金森病嗅球铁含量的初步研究目的：采用双回波序列对嗅球进行T2值的定量分析，探讨双回波技术评价嗅球铁含量的可行性，以及帕金森病嗅球铁含量的变化特点，及其在帕金森病嗅觉障碍诊断中的价值。方法：采用Philips Achieva1.5T超导型全身磁共振成像仪和16通道头-颈联合线圈，对30例存在嗅觉障碍的PD患者及30例正常对照组进行双回波序列冠状位扫描，并测量嗅球双回波序列的T2值。PD组与对照组之间嗅球T2值比较采用两独立样本t检验；PD组嗅球T2值与病程相关性采用控制年龄的偏相关分析。结果：PD组与正常对照组嗅球T2值分别为113.22±17.06s、125.54±9.43s，两者比较差异有统计学意义（t=3.461, P=0.001）；PD组病程与嗅球T2值有明确相关性（r=-0.402, P=0.03）；PD组H-Y I级与H-Y II级嗅球T2值分别为109.22±15.81s、114.05±12.57s，两者比较差异无统计学意义（t=0.866, P=0.398）。结论：帕金森病患者嗅球T2值明显减低，反映嗅球铁含量异常增加，并且嗅球T2值与病程有明确相关性。双回波成像嗅球铁定量分析在帕金森病嗅觉障碍诊断中有较高的应用价值。第三部分磁共振弥散张量成像在帕金森病嗅觉障碍诊断中的应用价值研究目的：应用磁共振弥散张量成像（DTI）测量嗅觉相关中枢结构的FA值，探讨FA值评价帕金森病嗅觉相关中枢功能状态的临床应用价值。方法：采用Philips Achieva1.5T超导型全身磁共振成像仪和16通道头-颈联合线圈，对24例存在嗅觉障碍的PD患者及30例正常对照组进行颅脑15个方向的DTI扫描，分别测量直回、海马及海马旁回、梨状皮质及杏仁核周围皮质（PCA）的FA值，并生成纤维束走行图。PD组与对照组之间的FA值比较采用两独立样本t检验；PD组及对照组左右两侧嗅觉相关中枢结构的FA值比较采用配对样本t检验。结果：PD组与对照组PCA区FA值分别为0.396±0.045、0.463±0.037，两者比较差异有统计学意义（t=6.059, P 0.001）；PD组ROI纤维束数目明显少于对照组。PD组与对照组直回FA值（分别为0.466±0.038、0.474±0.043; t=1.133, P=0.263）、海马及海马旁回FA值（分别为0.424±0.026、0.434±0.029; t=1.289, P=0.203）比较差异均无统计学意义。PD组左右两侧嗅觉相关中枢结构FA值（直回0.466±0.038、0.459±0.038, t=0.639、P=0.526;海马及海马旁回0.424±0.026、0.433±0.031, t=1.124、P=0.267; PCA0.396±0.045、0.405±0.042, t=0.743、P=0.461）及对照组左右两侧嗅觉相关中枢结构FA值（直回0.474±0.043、0.478±0.075, t=0.234、P=0.815;海马及海马旁回0.434±0.029、0.450±0.034, t=1.990、P=0.052; PCA0.463±0.037、0.465±0.048,t=0.168、P=0.867）分别比较，差异均无统计学意义。结论：帕金森病患者感兴趣区的纤维束数目减少，PCA区FA值明显减低。磁共振弥散张量成像可在体评估PD嗅觉相关中枢的功能状态，对PD的早期诊断具有一定的参考价值。
[Abstract]:Application of the first partial high resolution magnetic resonance imaging in the measurement of olfactory bulb volume and olfactory groove depth in Parkinson ' s disease

Objective : To evaluate the clinical application value of olfactory bulb volume and olfactory groove depth on olfactory dysfunction in patients with Parkinson ' s disease by high resolution magnetic resonance imaging of olfactory bulb and olfactory groove .

Methods : 40 cases of PD patients with olfactory disorder and 30 normal controls were imaged with high resolution magnetic resonance coronal images by Philips detachable eva1.5T superconducting whole - body magnetic resonance imager and 16 - channel head - neck combined coil . The olfactory bulb volume and olfactory groove depth were measured respectively . The olfactory bulb volume and the depth of olfactory groove were compared between PD and control groups .

Results : The volume of olfactory bulb in PD group and control group were 10.38 卤 4.66mm3 and 18.68 卤 10.84mm3 , respectively . There was significant difference between them ( t = 6.135 , P 0.001 ) .
The depth of olfactory sulcus in PD group and control group were 10.97 卤 1.826mm and 11.55 卤 1.89mm , respectively . There was no significant difference between PD group and control group ( t = 1.296 , P = 0.199 ) . There was no statistical difference between PD group H - Y grade I and H - Y grade II olfactory bulb volume ( 11.48 卤 6.04mm3 , 9.83 卤 3.12 mm3 , t = 1.131 , P = 0.265 ) and olfactory groove depth ( 11.04 卤 2.15mm , 10.92 卤 1.59mm , t = 0.224 , P = 0.824 ) .

Conclusion : The volume of olfactory bulb in patients with Parkinson ' s disease is obviously reduced , and the quantitative analysis of olfactory bulb volume by high resolution magnetic resonance imaging can help to evaluate the olfactory dysfunction of Parkinson ' s disease .

A preliminary study on the evaluation of iron content in the olfactory bulb of Parkinson ' s disease by the second partial magnetic resonance double echo sequence T2

Objective : To explore the feasibility of double echo technique to evaluate the content of olfactory bulb iron and the change of olfactory bulb iron content in Parkinson ' s disease and its value in the diagnosis of olfactory disorder of Parkinson ' s disease by quantitative analysis of T2 value of olfactory bulb by double echo sequence .

Methods : 30 cases of PD patients with olfactory disorder and 30 normal controls were scanned with double echo sequence coronal images by Philips detachable eva1.5T superconducting whole - body magnetic resonance imager and 16 - channel head - neck combined coil . The T2 values of olfactory bulb double echo sequence were measured .
Correlation analysis of control age was adopted in PD group olfactory bulb T2 value and course correlation .

Results : The T2 values of olfactory bulb in PD group and normal control group were 11.22 卤 17.06s and 125.54 卤 9.43s , respectively . There was significant difference between the two groups ( t = 3.461 , P = 0.001 ) .
There was a clear correlation between the PD group and the value of the olfactory bulb T2 ( r = - 0.402 , P = 0.03 ) .
In PD group , the values of H - Y I and H - Y II olfactory bulb T2 were 109.22 卤 15.81s and 114.5 卤 12.57s , respectively . There was no significant difference between them ( t = 0.866 , P = 0.398 ) .

Conclusion : The value of olfactory bulb T2 in patients with Parkinson ' s disease is significantly decreased , which reflects the abnormal increase of olfactory bulb iron content and the relationship between the value of olfactory bulb T2 and the course of disease .

Application of the third partial magnetic resonance diffusion tensor imaging in the diagnosis of olfactory dysfunction in Parkinson ' s disease

Objective : To evaluate the value of FA in evaluating the functional status of olfactory related central nervous system in patients with Parkinson ' s disease by using diffusion tensor imaging ( DTI ) .

Methods : Twenty - four PD patients with olfactory dysfunction and 30 normal controls underwent DTI scanning in 15 directions . The FA values of direct gyrus , hippocampus and parahippocampal gyrus , pear - like cortex and peripheral cortex ( PCA ) were measured .
The FA values of olfactory - related central structures on both sides of PD and control groups were compared with paired t - test .

Results : The FA values of PCA in PD group and control group were 0.396 卤 0.045 and 0.463 卤 0.037 , respectively . There was significant difference between the two groups ( t = 6.059 , P 0.001 ) .
There was no significant difference between PD group and control group . The FA values of olfactory - related central structures ( 0.446 卤 0.028 , 0.474 卤 0.043 , t = 1.133 , P = 0.629 , t = 1.124 , P = 0.267 , P = 0.641 , 0.405 卤 0.042 , 0.450 卤 0.034 , 0.465 卤 0.048 , t = 0.168 , P = 0.867 ) on both sides of PD group were significantly lower than those in control group .

Conclusion : The number of fiber bundles in the region of interest of Parkinson ' s disease is decreased and the FA value in PCA region is obviously reduced . MR diffusion tensor imaging can be used to evaluate the functional status of PD olfactory related central nervous system in vivo , and has certain reference value to the early diagnosis of PD .

【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R742.5

【参考文献】