| Objective:To investigate the changes of function and iron deposition in brain regions of interest and the relationship between them of Parkinson's disease(PD)patients by Blood oxygenation level dependent-functional magnetic resonance imaging(BOLD-fMRI)and Susceptibility weighted imaging(SWI),at the same time,observing the changes of bilateral "swallow tail" in PD patients compared with normal people,providing new theoretical basis for the early diagnosis of PD.Materials and Methods:Including in the December 2015-March 2017 The First Hospital of Lanzhou University clinical diagnosis of PD in 43 patients as experimental group(PD group),the 43 cases of PD patients' diagnostic criteria are all met the criteria of PD clinical diagnosis latest released by the Movement Disorder Society(MDS)in 2015,they had undergone various clinical specific exams to rule out the history of nervous illness,mental illness,head trauma and other diseases that may affect the central nervous system other than the history of PD,their aged50-80 years old,course of 1-10 years,level of education for 4-14 years,are all right-handed.In addition,30 healthy volunteers whose age and level of education matched with PD group and right-handed were included as normal control group(NC group),they had undergone various clinical specific exams that are the same as the PD group to rule out the history of nervous illness,mental illness,head trauma and other diseases that may affect the central nervous system.PD group and NC group were performed 3.0T MR cranial routine scanning,after images browsing,PD group ruled out 5 patients with more calcification and blood vessel shadow,and then,a total of38 patients were included in the PD group,including 21 males and 17 females,and there were no change in age,level of education and course of disease,and the course of these PD patients was(4.70±2.98)years on average.NC group were in line with the standard,did not rule out,total is still 30 cases,including 14 males and 16 females.Using a completely randomized two-sample t test to compare the age and level of education of the two groups,at the same time,Chi-square test was used to compare the gender distribution of the two groups,the results showed that there wasno significant difference in age,level of education and gender between the two groups.Using the BOLD sequence,MATLAB 2013 b,SPM8,DPARSFA2.3 and REST1.8 softwares,at the same time,the two-sample t test was used to analyze the functional changes of bilateral thalamus and striatum(caudate nucleus,putamen,globus pallidus)in PD group compared with NC group,the final result would be presented in the Non-invasive mapping of Amplitude of low-frequency fluctuation(ALFF).When measuring the phase values in Pha images and measuring the signal values in SWI images,we took nuclei of abnormal functional regions in ALFF maps as key measurements,if unilateral dysfunction of the nuclei,then continued to measure the anatomical symmetry of dysfunctional nuclei,the phase values and the signal values measured in this study were substituted into the formula ?=?-?×y/2048 in the form of variable y and converted to radian values as variable ?,finally,by comparing the radian values of bilateral thalamus,striatum(caudate nucleus,putamen,globus pallidus),substantia nigra and "swallow tail area",and red nucleus in Pha and SWI images in PD group with those in NC group used a completely randomized two-sample t test,we could get the changes of iron deposition in these brain regions of interest.We observed the existence of bilateral "swallow tail" in 38 PD patients in the PD group and 30 healthy volunteers in the NC group in SWI images and used a completely random design of two independent samples of the rank sum test for analysis and comparison.In addition to analysis of functional changes in regions of interest in the brain,all of the above statistical analysis used SPSS 22.0 software,P <0.05 was considered statistically significant.Results:In the ALFF map,there was significant differences regarding right caudate nucleus and bilateral putamen,globus pallidus between PD group and NC group,meanwhile,left caudate nucleus and bilateral thalamus for the PD group and NC group showed no significant difference.In the Pha images,the radian values of bilateral putamen,"swallow tail area",right caudate nucleus and globus pallidus and left substantia nigra in PD group decreased compared with those in NC group,and the difference was statistically significant(P <0.05),at the same time,there was no significant difference in radian values of bilateral thalamus,red nucleus,left caudate nucleus,globus pallidus and right substantia nigra in PD group compared with those in NC group(P> 0.05),In the SWI images,the radian values of bilateral putamen,globus pallidus,"swallow tail area",right caudate nucleus and left substantia nigra in PD group decreased compared with those in NC group,and the difference was statistically significant(P <0.05),at the same time,there was no significant difference in radian values of bilateral thalamus,red nucleus,left caudate nucleus and right substantia nigra in PD group compared with those in NC group(P> 0.05),these measurements show that in this study PD patients' bilateral putamen,"swallow tail area",right caudate nucleus and globus pallidus and left substantia nigra iron deposition increased more thannormal,and the left globus pallidus iron deposition may be more than normal.Among the 38 cases of PD patients in PD group,32 cases of bilateral "swallow tail" disappeared,5 cases of unilateral "swallow tail" disappeared and 2 of the 5 cases contralateral "swallow tail" fuzzy,1 case of bilateral "swallow tail" fuzzy,among the 30 cases of healthy volunteers in NC group,29 cases of bilateral "swallow tail" were present and the shape is clear,1 case of left "swallow tail" was fuzzy and the right "swallow tail" was clear.There was a difference in the existence of bilateral "swallow tail" between the PD group and the NC group,and the difference was statistically significant(P <0.05).The disappearing and blurred ratio of bilateral "swallow tail" in 38 PD patients in PD group was greater than the disappearing and blurred ratio of bilateral "swallow tail" in 30 healthy volunteers in NC group.Conclusions:Using BOLD-fMRI and ALFF map can measure and display the changes of brain function in brain regions of interest of PD patients,using Pha and SWI images can measure the changes of iron deposition in brain regions of interest of PD patients,The measurement results of this study suggest that there is abnormal iron deposition in the brain dysfunction area of PD patients.The presence of bilateral "swallow tail" in PD patients in SWI images can be used as a auxiliary reference condition for the early diagnosis of PD and may become a biological marker for the early diagnosis of PD through MRI images. |
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