Comparative Study of MRI Biomarkers in the Substantia Nigra to Discriminate Idiopathic Parkinson Disease
Comparative Study of MRI Biomarkers in the Substantia Nigra to Discriminate Idiopathic Parkinson Disease
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DOI：
10.3174/ajnr.a5702
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发表时间：
2018-08-01
影响因子：
3.5
通讯作者：
Lehericy, S.
中科院分区：
文献类型：
--
作者：
Pyatigorskaya, N.;Magnin, B.;Lehericy, S.
背景和目的：几种新的MR成像技术在帕金森病患者中显示出有希望的结果;然而，这些措施在个体水平上的比较诊断价值仍不清楚。我们的目的是比较黑质损伤的MR成像生物标志物对区分帕金森病患者和健康志愿者的诊断价值。材料与方法：前瞻性纳入36例患者和20例健康志愿者。3 T MR成像方案包括3D T2加权和T1加权神经黑色素敏感图像、扩散张量图像和R2* 标测。在7 T下采集T2* 高分辨率图像，以评估背侧黑质高信号征。在神经黑素敏感图像和T2加权图像上，使用在高信号强度区域周围手动绘制的黑质中的ROI进行定量分析。对黑质神经黑素敏感信号强度和背外侧黑质高信号T2* 图像进行视觉分析。结果：帕金森病患者的神经黑素敏感体积和信号强度显著降低。在3 T下，神经黑素敏感黑质的各向异性分数也显著降低，平均、轴向和径向扩散率增加，T2* 图像上黑质体积减少。黑质体积、信号强度和神经黑素敏感性黑质各向异性分数的组合允许极好的诊断准确性（0.93）。黑质背外侧高信号和神经黑色素敏感图像的视觉评估具有良好的诊断准确性（分别为0.91和0.86）。结论：黑质神经黑色素信号和体积变化与各向异性分数测量的组合显示出极好的诊断准确性。此外，使用背外侧高信号分析或神经黑素敏感信号变化对黑质变化进行视觉评估的高诊断准确性表明这些技术在临床实践中是有希望的。
BACKGROUND AND PURPOSE:Several new MR imaging techniques have shown promising results in patients with Parkinson disease; however, the comparative diagnostic values of these measures at the individual level remain unclear. Our aim was to compare the diagnostic value of MR imaging biomarkers of substantia nigra damage for distinguishing patients with Parkinson disease from healthy volunteers. MATERIALS AND METHODS:Thirty-six patients and 20 healthy volunteers were prospectively included. The MR imaging protocol at 3T included 3D T2-weighted and T1-weighted neuromelanin-sensitive images, diffusion tensor images, and R2* mapping. T2* high-resolution images were also acquired at 7T to evaluate the dorsal nigral hyperintensity sign. Quantitative analysis was performed using ROIs in the substantia nigra drawn manually around the area of high signal intensity on neuromelanin-sensitive images and T2-weighted images. Visual analysis of the substantia nigra neuromelanin-sensitive signal intensity and the dorsolateral nigral hyperintensity on T2* images was performed. RESULTS:There was a significant decrease in the neuromelanin-sensitive volume and signal intensity in patients with Parkinson disease. There was also a significant decrease in fractional anisotropy and an increase in mean, axial, and radial diffusivity in the neuromelanin-sensitive substantia nigra at 3T and a decrease in substantia nigra volume on T2* images. The combination of substantia nigra volume, signal intensity, and fractional anisotropy in the neuromelanin-sensitive substantia nigra allowed excellent diagnostic accuracy (0.93). Visual assessment of both substantia nigra dorsolateral hyperintensity and neuromelanin-sensitive images had good diagnostic accuracy (0.91 and 0.86, respectively). CONCLUSIONS:The combination of neuromelanin signal and volume changes with fractional anisotropy measurements in the substantia nigra showed excellent diagnostic accuracy. Moreover, the high diagnostic accuracy of visual assessment of substantia nigra changes using dorsolateral hyperintensity analysis or neuromelanin-sensitive signal changes indicates that these techniques are promising for clinical practice.