Study On Detection Of Iron Content That The Cerebral Deep Nucles Of WD Patients Through Swi And Relationship Between The Iron Content And Clinical Features

Objective:1.To study the difference of the iron content between Wilson disease (WD group) and normal control group (NC group). through the gray matter nuclei (putamen caudate nucleus, globus pallidus, thalamus, substantia nigra, red nucleus) by brain SWI examination.2.To investigate the differences of iron concentration in deep gray matter nuclei (above-mentioned nucleus) between the subtypes of WD group.3.To learn the correlations between iron metabolism and clinical manifestations、 TCM typing and WD gene mutations, and to explore the underlined mechanisms of the abnormal iron metabolism.Methods:Thirty three Wilson patients without standard anticopper treatment (WD group) and13healthy people (NC group) were recruited. WD group patients were divided into three subtypes according to previous CMRI scan results:15cases with hyperintensity on T1and T2-weighted images in the basal ganglia(long T2group),11cases with hyperintensity mixed with hypointensity on T2-weighted images in the basal ganglia(short T2group) and7cases with non-CMRI signal(WD control group).serum CP, Sco, Gene mutations, liver B ultrasound,K-F ring and gene mutations were detected for all patients of WD group,and recorded clinical data.SWI sequence checking was administrated for all subjects. To study the differences between these groups nuclei phase value using the statistical software,and to learn the correlations between iron metabolism and clinical manifestations、B ultrasound、K-F ring、TCM syndrome types and gene mutation.Results:1. There were significant difference in the phase values on both side of the caudate nucleus in NC group. 2.WD group comparied with NC group:There were significant difference between the phase values of red nucleus in these two groups (p<0.05), There were highly significant difference on other nuclears(p<0.01).3.Between NC group and subgroups of WD group:There were significant difference between short T2group and NC group of above-mentioned nucleus phase values, there were highly significant differences between long T2group and NC group of all the above-mentioned nucleus except the red nucleus and left globus pallidus, there were multiple nucleus had significant difference between the rest groups compared with the others.4.Compared with each other nucleus in the NC group:phase values between the nucleus had highly significant difference. Compared with each other nucleus in the NC group:phase values between the nucleus had highly significant difference.5.Comparison of different clinical classification type of WD:the phase values of left caudate nucleus, putamen had highly significant difference between each group.6.WD group comparing different types of Chinese medicine, the phase values of left putamen, right thalamus had significant difference between Yin deficiency of liver and kidney and two blood loss types. Conclusions:1.Actually it had the abnormality of iron metabolism in patients with WD. The iron content of brain deep gray nucleus were significantly higher than the normal group. All the nuclei’s iron content of the short T2group were increased in the subtyper of WD, long T2group slightly lighter, WD iron content were increased at least in the control group.2.For all the subjects, the highest level of iron concentration was showed in substantia nigra, while the lowest was in the hypothalamus. WD patients had higher iron concentration of each nucleus compared with NC patients. Putamen iron content was the highest, followed by the caudate nucleus,thalamus iron content increased minimum. The nucleis that abnormal increased of iron content of WD was similar to the damaged nucleis by conventional MRI scan found.3.Iron concentrations in caudate nucleus and putamen of hepatic type WD were lower than other types, which was according the fact most hepatic subtype patients without extrapyramidal symptoms.4.WD group of liver-kidney type with two blood loss, the former right thalamus slightly higher iron content, which were slightly higher iron content in the left putamen.5. Between the groups of different gene types, the iron content of each nucleus were no significant difference.