Functional Magnetic Resonance Study Of Parkinson's Disease

PartⅠPhase images in study of quantifying brain ironObjective: To explore whether the phase images has potential for quantifying brain iron invivo.Methods : Thirty healthy adult volunteers (20 males,10 females ) were studied with a GE1.5 T scanner. The subjects ranged from 20 to 65 years old ( mean = 36). All subjects wereimaged with SWI sequence. The correct phase shift value (CP) of substantia nigra (SN),red nucleus (RN),, globus pallidus (GP), putamen (PU), caudate (CA) and thalamus (TH)were measured on the corrected phase images. Regional CP values were compared withpublished brain iron concentration by linear correlation analysis.Results : The SN, RN and GP showed symmetrically homogeneous low intensity both inthe CP images and SWI reconstruction images. And their mean CP value were -0.1554,-0.1272, -0.1119, -0.0807 and -0.1034, Significant difference was demonstrated at the CPvalues of ROI and white matter (p＜0.01). There was negative linear correlation betweenCP value and brain iron store (R=-2.81, p=0.048＜0.05), y=-0.0058x-0.0152.Conclusions : The phase shift images could be used to detect minor iron concentrationdifferences in the brain. There was negative linear correlation between CP value and brainiron store in 1.5 T MR. The phase shift images may be useful for estimating the amount ofbrain iron in vivo. PartⅡApplication of MR Susceptibility Weighted Imaging inthe Differential Diagnosis of Intracranial Calcification and IronAccumulationObjective: To study the signal character of intracranial calcification and ironaccumulation by using MR SWI (susceptibility weighed imaging, SWI) technology, andevaluate the value of SWI sequence in diagnosis of intracranial lesions.Methods: The materials of 13 cases with intracranial calcification and 20 cases volunteerMRI(including routine T1Wi,T2Wi and SWI) were collected. All calcification areconfirmed by CT scan with their CT value beyond 90 HU . And the 20 volunteersrepresentiron accumulation group. 3D-SPGR(3D spoiled gradient echo) sequence is applied insusceptibility weighed imaging. Magnitude images and phase images are obtained. AndSWI reconstruction images will be obtained at the workstation AW4.2 . The MR signalcharacter of 56 calcification and that of substantia nigra in 20 volunteers werecompared..The CP(corrected phase ,CP) values of calcification ,substantia nigra andnormal alba are measured in corrected phase images. And statistical analysis is carried out.Results: All 55 (98.2%) calcification were well demonstrated in SWI sequence. Incorrected phase images, calcification showed high signal intensity or heterogeneously highsignal intensity, and hypointensity in SWI reconstruction images. 40 substantia nigrarepresenting iron accumulation showed extremely homogeneous low intensity both incorrected phase and SWI reconstruction images. The CP value of calcification is+0.734±0.073 ; The CP value of alba is +0.002±0.007 .There is significant differencebetween calcification and alba (t=8.6305,p＜0.01). There is significant differencebetween substantia nigra(-0.092±0.016) and alba (t=-5.3293,p＜0.01).Conclusion: SWI has high sensitivity in detection of iron accumulation and intracranial calcification. The signal difference in phase corrected images is valuable in differentialdiagnosis of intracranial calcification and iron accumulation.PartⅢThe quantitative study of iron stores in the brain ofParkinson's diseaseObjective: To explore MR technology for the quantitative study of iron store inbrain. And to invest the relationship between PD's pathogenesy and progress and ironstore in brain.Methods : 10 PD patients with unilateral symptoms and 20 PD patients with bi-lateralsymptoms were enrolled in PD group 1 and PD group 2. The 30 PD patients included 22males and 8 females .The average age was 57.7 years old (38-74). The PD group and thecontrol group which including 30 age and sex matched healthy volunteers were underwentthe routine MR plain scan and SWI scan. The phase correction value (CP) of substantianigra, red nucleus, globus pallidus, putamen, caudate and thalamus were measured inCP imaging. The statistical analysis was underwent.Result : There was negative linear correlation between CP value and iron store (R=-2.81,p=0.048＜0.05) . The CP value of substantia nigra , red nucleus, globus pallidus andputamenl were significantly lower in PD groups (p＜0.05). No significant difference wasdemonstrated at CP value of caudate and thalamus (p＞0.05). No significant differencewas demonstrated at CP value of all ROI between PD group 1 and PD group 2 (p＞0.05).And no significant difference was demonstrated at the CP value between the two sides ofthe PD group 2.Conclusions : 1) There was negative linear correlation between CP value and iron store. 2)Increasing of iron store concerned with PD's pathogenesy, not with severity degree. 3) There has abnormal iron store before clinical period. 4) The site of pathologic iron storeinclude substantia nigra, red nucleus, globus pallidus, putamen, not including caudateand thalamus.PartⅣDTI study of Parkinson's diseaseObjective: To investigate the diffusion tensor imaging (DTI) change on extracorticospinaltract and some domain in Parkinson's disease (PD). To explore some clues for PD's earlydiagnosis. And to explore the relationship between DTI and PD.Methods: 10 PD patients with unilateral symptoms and 20 PD patients with bi-lateralsymptoms were enrolled in PD group 1 and PD group 2. The 30 PD patients included 22males and 8 females .The average age was 57.7 years old (38-74). The PD group and thecontrol group which including 30 age and sex matched healthy volunteers were underwentthe routine MR plain scan and DTI scan .There would be FA imaging and ADC imagingafter postprocessing. And the FA values and ADC values of ROI (region of interest) weremeasured .The ROI included SN (substantia nigra),NR (red nucleus),GP (globuspallidus),PUT (putamen),CN (caudate nucleus),thalamus,genu of corpus callosum,splenium of corpus callosum,callosal gyms,white matter of frontal lobe and anteriorcentra gyms. All data were analyzed.Results : The FA value of SN,CN and thalamus of PD group degraded obviouslycompared with control group (p＜0.05).The FA value of PD group 1 degraded comparedwith that of PD group 2. There was significant diference at SN's FA value between thetwo sides of PD group 2. The FA value of splenium of corpus callosum of PD groups weresignificant lower than control group. The FA value of PD group 1 was lower compared withcontrol group and PD group2 at anterior central gyms and callosal gyms (p＜0.05). There was no significant diference among PD groups and contra group at other ROI's FA value.And there was no significant diference between PD group 1 and PD group 2 at other ROI.There were no significant diference at ADC value among PD group 1,PD group 2 andcontrol group .But there was an increasing tendency at ADC value along with the progressof PD.Conclusions: The FA values of SN,CN,thalamus and splenium of corpus callosum offeredsome important informations for the early diagnosis of PD.There was negative correlationbetween the change of FA value at SN and PD grade.The FA values of callosal gyrus andanterior central gyms decreased at advanced stage of PD .DTI was useful to the study aboutPD's pathomechanism and clinical manifestation in vivo.PartⅤMagnetic resonance spectroscopy study on basal gangliadomain of idiopathic Parkinson's diseaseObjective : To analyze the metabolism change on basal ganglia of idiopathic Parkinson'sdisease. And to explore the clinical application of magnetic resonance spectroscopy (MRS)on Parkinson's disease (PD).Methods : 15 PD patients and 8 healthy volunteers underwent MRS study on their basalganglia. Among them ,10 PD patients and the volunteers underwent single-voxel MRSstudy. And 5 PD patients underwent multi-voxel MRS study.Results : NAA/Cr radio on lenticular of PD patients were decrease .There was no statisticsdifference on Cho/Cr radio between the PD patients and volunteers. NAA/Cr radio of PDpatients was asymmetry in 2D multi-voxel MRS study.Conclusions: H-MRS was a useful technique in study the function and quantity of basalganglia neuron of PD. 2D multi-voxel MRS lend itself to the study of PD. The NAA/Cr radiochange was the reaction of the pathology change of PD.