The Diagnostic Value Of T2 Mapping And Diffusion Kurtosis Imaging Quantified Parameter In Cerebral Hepatolenticular Degeneration

Objective:To investigate the changes of transverse relaxation time(T2 value)and microstructural quantified parameter in patients with cerebral hepatolenticular degeneration(HLD)using T2 mapping sequence and diffusion kurtosis imaging(DKI),and the correlation with modified Young scale,serum ceruloplasmin,serum copper,24-hour urinary copper were analyzed.Materials and methods:30 patients with cerebral type HLD(HLD group)and 30 sex and age matched normal volunteers(control group)were collected for brain routine MRI scan,T2 mapping sequence scan and DKI sequence scan;The differences of T2 values,mean kurtosis(MK)and mean diffusivity(MD)in lenticular nucleus,thalamus,caudate head,midbrain,pons,medulla oblongata,dentate nucleus of cerebellum,cerebellar hemisphere,white matter of cerebral hemisphere,corpus callosum were compared,The receiver operating characteristic curve(ROC)was used to analyze the diagnostic efficacy of each parameter(T2 value,MK value and MD value)in evaluating brain damage in cerebral type HLD.The HLD patients were evaluated by the modified Young scale,and the laboratory data of serum ceruloplasmin,serum copper and 24-hour urinary copper in HLD patients were collected.The correlation between T2 value,MK value,MD value and modified Young scale score,serum ceruloplasmin,serum copper and 24-hour urinary copper were analyzed.Results:1.T2 value in T2 mapping:The T2 values of lenticular nucleus,thalamus,caudate head and cerebellar dentate nucleus in HLD group were lower than control group,and there were significant differences in lenticular nucleus and caudate head;The T2 values of midbrain,pons,medulla oblongata,cerebellar dentate nucleus,cerebellar hemisphere,cerebral hemisphere white matter and corpus callosum were higher than the control group.There were significant differences in pons,parietal lobe white matter,temporal white matter,occipital lobe white matter,body and splenium of corpus callosum.The T2 value of temporal white matter had the best diagnostic efficiency in evaluating brain damage,and the area under the ROC was 0.834.2.MK value in DKI:The MK values of lenticular nucleus,thalamus,caudate head,midbrain,pons,cerebellar hemisphere,cerebral hemisphere white matter and corpus callosum in HLD group were lower than the control group.There were significant differences in lenticular nucleus,caudate head,midbrain,frontal lobe white matter,parietal lobe white matter,occipital lobe white matter and corpus callosum;The MK value of medulla oblongata and cerebellar dentate nucleus was slightly higher than the control group,and the differences were not statistically significant.The MK value of genu of corpus callosum had the best diagnostic efficiency in evaluating brain damage,and the area under the ROC was 0.911.3.MD value in DKI:The MD values of lenticular nucleus,thalamus,caudate head,midbrain,pons,medulla oblongata,cerebellar dentate nucleus,cerebellar hemisphere,cerebral hemisphere white matter and corpus callosum in HLD group were higher than the control group.There were significant differences in lenticular nucleus,caudate nucleus head,midbrain,cerebellar dentate nucleus,frontal lobe white matter,parietal lobe white matter,occipital lobe white matter and corpus callosum.The MD value of lenticular nucleus had the best diagnostic efficiency in evaluating brain damage,and the area under the ROC was 0.905.4.The correlation of T2 value,DKI quantitative parameters and clinical and laboratory indicators:① T2 value:The T2 value of lenticular nucleus was negatively correlated with the modified Young score;T2 values of frontal white matter and parietal white matter were positively correlated with 24-hour urinary copper.② MK value:The MK value of thalamus was positively correlated with serum copper,and the MK values of cerebellar dentate nucleus,genu,and splenium of corpus callosum were negatively correlated with serum copper.③ MD value:The MD values of midbrain and genu of corpus callosum were negatively correlated with serum ceruloplasmin.The MD value of serum copper was positively correlated with genu of corpus callosum.Conclusion:1.T2 mapping can quantify the brain damage of cerebral HLD patients through T2 value.Different parts of the brain may have different pathological processes.DKI quantified parameter can demonstrate the microstructural changes in cerebral type HLD patients.The T2 value of temporal white matter,MK value of genu of corpus callosum and MD value of lenticular nucleus have good diagnostic efficiency in evaluating brain damage in cerebral HLD.2.T2 values,MK values,MD values and some clinical and laboratory indicators of cerebral HLD have a certain correlation,which can provide a certain reference for clinical practice.