| Objective The pathogenesis of multiple system atrophy(MSA)is not clear.To explore the iron deposition in different brain regions of MSA is helpful to further understand the influence of iron deposition on the pathophysiology of MSA,and to provide theoretical basis for diagnosis and efficacy evaluation.Based on the quantitative magnetic resonance magnetic susceptibility imaging(QSM),the quantitative analysis and study of iron deposition in different brain regions of MS A patients were carried out in order to further understand the pathogenesis and pathogenesis of MSA patients through the difference of iron deposition in brain regions,and provide sensitive indicators for the early diagnosis and efficacy evaluation of multiple system atrophy.Method From January 2019 to December 2019,23 patients who met the diagnostic criteria of MSA were selected from Oriental Hospital of Beijing University of traditional Chinese medicine,including 8 patients of MSA-P,15 patients of MSA-C and 21 normal people as the control group.Quantitative magnetic resonance magnetic susceptibility imaging(QSM)was performed.The cerebellar dentate nucleus,substantia nigra,red nucleus,caudate nucleus,putamen nucleus and pallor were manually delineated on the magnetic sensitivity map The ROI of the gray matter areas such as the ball and thalamus,and the white matter areas such as the upper cerebellar foot,the middle cerebellar foot,the lower cerebellar foot,the knee of the corpus callosum,the body of the corpus callosum,and the pressure of the corpus callosum were obtained.The magnetic sensitivity values of the ROI of the corresponding areas were obtained through the sketched areas,and the measured magnetic sensitivity values were statistically analyzed in combination with the corresponding dataResults 1.There was no significant difference in age between the two groups.2.The total amount of iron deposition in the control group was 1.396118ppm,and that in the MSA group was 1.605143ppm.The amount of iron deposition in the brain in the MSA group was significantly higher than that in the control group.3.The amount of iron deposition in gray matter area of MSA group accounted for 86%of the total,while that in control group accounted for 84%.4.The amount of iron deposition in white matter and gray matter of MSA group and control group was analyzed,The iron deposition in gray matter area of MSA group was higher than that in the control group,except for the lower cerebellar foot,the knee of corpus callosum and the pressing part of the white matter area,the iron deposition in other parts of MSA group was higher than that in the control group;the age-related analysis showed that the left substantia nigra was negatively correlated with age,and the left putamen nucleus was positively correlated with age;5.The iron deposition analysis showed that MSA group and the control group existed in the following parts There were significant differences,including left cerebellar dentate nucleus,left substantia nigra,right substantia nigra,left red nucleus,right caudate nucleus,left putamen nucleus,right globus pallidus,left thalamus,right thalamus,right middle cerebellar foot,left inferior cerebellar foot,right inferior cerebellar foot;6.The results showed that there were significant differences between MSA-C group and MSA-P group in the left putamen,the left globus pallidus,the right globus pallidus,the left thalamus and the right thalamus,and the iron deposition of MSA-P group was significantly greater than that of MSA-C group,MSA-C group and MSA-P group in the upper cerebellum,There were differences between the corpus callosum and the control group,and the amount of iron deposition in MS A-C group was significantly higher than that in MSA-P group;7.ROC curves of the left thalamus,the right thalamus and the right middle cerebellar foot in the MSA group and the control group were analyzed.The results showed that the best diagnostic threshold of the left thalamus was 0.0339ppm,the sensitivity was 71.4%,the specificity was 87%,and the AUC area was 0.871;the best diagnostic threshold of the right thalamus was 0.03405ppm,the sensitivity was 76.2%,the specificity was 87%,and the AUC area was 0.874;the best diagnostic threshold of the right middle cerebellar foot The value was-0.01675ppm,the sensitivity was 76.2%,the specificity was 65.2%,and the AUC area was 0.724.The ROC curves of the right pallidum and the right upper cerebellar foot in MSA-P group and MSA-C group were analyzed.The results showed that the best diagnostic threshold of the right pallidum was 0.1415ppm,the sensitivity was 87.5%,the specificity was 86.7%,the AUC area was 0.879;the best diagnostic threshold of the right upper cerebellar foot was-0.03185ppm,the sensitivity was 87.5%,the specificity was 66.7%,and the AUC area was 0.754;8.The results showed that there was a significant positive correlation(r=0.495,P=0.022).Conclusion QSM technology can accurately measure the changes of iron content in gray matter area of brain in MSA patients,and it is closely related to clinical scale score and MSA subtype,which has important value for the differential diagnosis and efficacy evaluation of MSA. |
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