| Objective:To study the SWI characteristics of nuclei in Parkinson’s disease (PD) and to explore the relationship between PD pathogenesis and cerebral iron distribution.Materials and Methods:For the period ranging from October 2014 to February 2015, patients admitted to the First Affiliated Hospital of Dalian Medical University were screened for primary parkinsonism. Among 58 cases collected,32 were males,26 were females. All PD patients were staged according to Hoehn-Yahr scale (HY), among which there were 33 cases belonging to HY<2, are early stage PD. There were 25 cases belonging to HY>2, are late stage PD. The American GE Signa EXCITE HD 1.5 Tesla superconducting MRI scanner with 8-channel phased-array head coil was used throughout this clinical trial. The above mentioned three groups of patients were subjected to SWI, TlW1-FLAIR, FSE-T2WI, T2WI-FLAIR exams. Based on the signal intensity of each nucleus with the surrounding cerebral tissue, border clarity and etc, two experienced radiologists divided the images into four grades 1,2,3,4. Caput caudatus (CNc), putamen (PUT), medial part of the globus pallidus (GPi), red nucleus (RN), substantia nigra (SN) were compared using SWI, T1W1-FLAIR, FSE-T2WI, and different sequences of T2WI-FLAIR images. On SWI corrected phase, the region of interest (ROI) was selected, and the distribution phase value of each nucleus in PD and control group was measured. This retrospective cross-sectional analysis via SWI revealed substantia nigra’s "swallow tail" sign, as well as the sensitivity and specificity of PD and NC group. The collected data were analyzed using SPSS 19.0 software.Results:1.Different sequences showed significant differences in the quality of the ROI (P <0.05):during SWI sequence, each nucleus displayed a relatively average good signal and were uniform, with sharp and clear borders). On FSE-T2WI, TIWI-FLAIR, T2WI-FLAIR imaging, signal contrast between the majority of nuclei and surrounding adjacent tissues were poor, with non-uniform and unclear borders, which were difficult to distinguish.2.Comparison of phase value on the left and right side in early stage, late stage PD and NC group revealed no significant differences (P> 0.05).3.There is a negative correlation between the different cerebral regions phase values of the NC groups and the actual measured values of cerebral iron content reported in the literature.(R2=-O.897,P=0.006).4.When CNc and GP phase values were compared, the NC group and late stage PD group showed difference (P<0.05=, whereas no difference was noted between early stage PD and NC group, early stage PD and late stage PD group (P<0.05).5.When PUT, RN, SN phase values were compared, early and late stage PD groups were different from NC group. (P<0.05)6.Nigrosome-1 on SWI in NC group appears as a "swallow tail" sign, whereas PD group patients lack it. Diagnostic accuracy:91%, sensitivity:100%, specificity 90% and the results were statistically significant (P<0.001).Conclusion:1.SWI sequence can more clearly display the extrapyramidal nuclei than normal MRI sequence.2.PD patients have an abnormal high content of iron in the substantia nigra, red nuclei and other parts, which is related to the pathogenesis of PD.3."Swallow tail" sign, which is missing in the PD patients, provides a new, easy-to-apply diagnostic tool for the early state PD. |
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