Study On Quantitative Diagnosis Of Mri In Parkinson’s Disease

Section Ⅰ Study on the Application of Magnetic Resonance Spectroscopy with MEGA-PRESS Sequence in Parkinson’s DiseaseObjectives To study the changes of GABA/Cr,NAA/Cr and Cho/Cr ratios of basal ganglia in PD patients by 3.0T MR MEGA-PRESS sequence,and to detect GABA level changes by LCModel software and to study the relationship between metabolite concentration changes and PD.Materials and Methods 45 patients who met PD diagnostic criteria and 47 controls who were matched upon age and gender were enrolled.Relevant scales evaluations were performed before MRI.3.0T Siemens Magnetic Resonance Scanner combined with 3D T1WI was performed for MRS orientation.ROI covers right corpus striatum,left corpus striatum and substantia nigra.Areas under the curves were calculated for the NAA,Cho and Cr metabolites in EDIT OFF Spectroscopy to achieve the ratios of NAA/Cr and Cho/Cr after spectrum data collection;while the area under the curve was calculated for GABA within the GABA Spectroscopy editing to achieve GABA/Cr ratio.MR Spectroscopy original data were imported into LCModel software manually and valid GABA level was calculated accordingly.Relevant data were analyzed by SPSS 19.0.Results(1)In the control group,the NAA/Cr,Cho/Cr and GABA/Cr ratios as well as GABA level of bilateral corpus striatum showed no significant differences(P>0.05,and t values are-0.72,-0.164,-0.104 and 0.77).(2)For PD patients,the differences of NAA/Cr,Cho/Cr and GABA/Cr ratios as well as GABA level between ipsilateral and contralateral corpus striatum were without significance(P>0.05,and the t values are 0.077、0.606、-1.026、-0.478).(3)For the comparison between PD group and control group,there were significant difference between the NAA/Cr and Cho/Cr ratios of corpus striatum and substantia nigra with respective P values of 0.000,0.003,0.045,0.023,0.029 and 0.037 as well as t values of-4.118,2.239,2.209,2.315,-1.239 and-1769;while the NAA/Cr ratio decreased and the Cho/Cr ratio and GABA level increased.The GABA/Cr level of corpus striatum and substantia nigra in the PD group was higher than that of control group without statistical significance(P>0.05,-3.301,-0.750).Conclusions With the MEGA-PRESS sequence of 3.0T MR,together with GABA level of PD brain determinded with LCMoel software,it can be concluded that:(a)3.0T MEGA-PRESS sequence scan combined with LCMoel software would determine brain GABA level objectively and precisely;(2)In PD patients,NAA/Cr ratio of corpus striatum and substantia nigra decreases,while the Cho/Cr ratio and GABA level increases;(3)MRS would determine quantitatively the metabolite changes in PD brains,which contributes to diagnosis,differential diagnosis,as so to be a promising non-invasive detection method of biological marker for PD.Section Ⅱ Study on Basal Ganglia Nuclei Iron Deposition Detection with Susceptibility Weighted Imaging in PDObjectives To discuss the feasibility of various basal ganglia nuclei iron level detection with SWI phase diagram,and to study the relationship between iron level changing and clinical in PD patients.Materials and Methods 42 patients who met PD diagnostic criteria and 41 controls who were matched upon age and gender were enrolled.Relevant scales evaluations were performed before MRI.3.0T Siemens Magnetic Resonance Scaner was adopted with routin T1WI,T2WI and FLAIR sequences as well asSWI sequence.Phase pushing figures of bilateral red nucleus,substantia nigra,caudate nucleus head and putamen were determined by phase diagrams;then,the formula f(x)=-x.π/4096(X refers to phase radians)was adopted to calculate phase value which is located between +π and-π.For the nuclei of substantia nigra,caudate nucleus head and putamen,6 round ROI of similar area for each were selected to represent phrase values of different positions for relevant calculation and analysis.Relevant data were analyzed by SPSS 19.0 statistical software package.Results(1)For the control group,the differences between substantia nigra and red nucleus,caudate nucleus and putamen were significant with obviously lower phrase values for substanita nigra(P=0.000).(2)For the control group,the differences of substantia nigra and red nucleus,caudate nucleus and putamen between female and male were without statistical significance.(3)For the control group,there were significant differences between left and right substantia nigra and red nucleus,while were not for left and right caudate nucleus and putamen phase valuses.(4)For control group,the phrase value of ventral substantia nigra was lower than dorsal part significantly(P=0.000 for the left,and 0.001 for the right).(5)In PD group,the comparison between PD-affected ipsilateral and contralateral substantia nigra,red nucleus,caudate nucleus were not significant(P=0.077,0.629,0.529 and 0.407).(6)The phase values of substantia nigra and putamen of the PD group were smaller than that of the control group,while no significant differences existed for the phase values of red nucleus and caudate nucleus(P=0.015,0.005,0.105 and 0.305).(7)The phases values for the front,middle and back substantia nigra in the PD patients were lower than the control ones(P=0.051,0.037 and 0.031).(8)Both phases values of ventral and dorsal substantia nigra of the PD group were significantly lower than the control group(P=0.043&0.035).(9)The back phase values of the bilateral putamen in the PD group were lower than the control group(P=0.236,0.065 and 0.000).(10)There ware no significant differences exist between the phase values of bilateral substantia nigra,red nucleus,caudate nucleus and putamen and disease courses(P=0.726,0.645,0.180 and 0.710).(11)The phase values of PD-affected ipsilateral and contralateral substanitia nigra,red nucleus,caudate nucleus and putamen did not correlateConclusions Multiple ROIs of basal ganglia nuclei were adopted innovatively in this study to calculate phase pushing figures and then to calculate the phase values of the identical basal ganglia nuclei via average.It can be concluded:(1)In PD patients,the iron levels of substantia nigra and putamen increased with a disseminated and synchronous growth of iron level in substantia nigra and focued back putamen iron level increased for the later.(2)PD course,total UPDRS score and motor score did not significantly correlate to the iron level of basal ganglia nuclei.(3)The phase value calculation with multiple ROIs of the identical basal ganglia nuclei would evaluate the iron level changes more objectively and precisely.Section Ⅲ Study on Magnetic Resonance Diffusion Tensor Imaging in PDObjectives To study the cerebral white matter microstructral anomalous changes in PD through diffusion tensor imaging(DTI)of fasciculus tract based spatial statisticsMaterialsand Methods 42 patients who met PD diagnostic criteria and 41 controls who were matched upon age and gender were enrolled.Relevant scales evaluations were performed before MRI.3.0T Siemens Magnetic Resonance Scaner was adopted with routin T1WI,T2WI and FLAIR sequences as well as SWI sequence.After DTI scanning,fsl4.0 software package was adopted to perform DTI image data processing and analysis;independent-sample T test was utilized to achieve the FA difference charts of the control and PD groups,meanwhile regions of differences were analyzed.White matter fiber tracts with significantly different FA values of the two groups were screened out with the statistical chart of the control group,the PD group and the two sample t test;and the FA values were calculated then.T-test for the fiber tracts FA values of both groups were performed by SPSS19.0 software,while P<0.05 was taking as statistical significance.Person correlation analysis method was adopted to analyze the relationship between total UPDRS score,motor score and respective white matter fiber tracts FA values in the PD group,while P<0.05 was taking asResults(1)Compared with the control group,the cerebral white matter fiber with significant lower FA values in the PD group covers bilateral front corona radiate,upper corona radiate,upper longitudinal fasciculus,anterior and posterior limbs of internal capsule,capsula externa,posterior thalamic radiation,optic radiation,sagittal layer(including inferior longitudinal fasciculus and frontooccipital inferior fasciculus),crus of fornix and stria terminalis,fornix,the genu,the body and the splenium of corpus callosum,bilateral superior cerebellar peduncle,left fasciculus uncinatus,right cingulum,right meddle cerebellar peduncle,and bilateral frontal,temporal and occipital lobes extensive subcortical arcuate fibres.(2)The FA values of anterior and posterior limbs of bilateral internal capsule,bilateral external capsule,bilateral posterior corona radiata,the body and the splenium of corpus callosum,and bilateral sagittal layer(including superior longitudinal fasciculus and frontooccipital inferior fasciculus)in the PD group were all significantly lower than that of the control group(P<0.005).(3)In the PD group,total UPDRS score and motor score did not correlate to the FA values of various white matter fiber tracts(P>0.05).Conclusions This study was to understand the microstructural changes of cerevral white matter in PD with DTI technology of TBSS;The followings were concluded:(1)In PD patients,microstructural changes of cerebral white matter existed extensively with the damage of white matter fiber tracts of downstream conduction path projection fibers(lateral corticospinal tract,cortex pons tract,corticobulbar tract,cortical striatal tract),limbic system related fiber tracts(cingulum,external capsule,fasciculus uncinatus,superior longitudinal fasciculus,sagittal layer),corpus callosum,posterior thalamic radiation,optic radiation and cerebellum white matter.(2)DIT is capable to determine quantitatively FA values of brain structures in PD patients without invasion as well as a sensitive method for quantitative evaluation of brain structures in PD with increasing significance in early diagnosis,differential diagnosisfor PD.