摘要
目的探讨多模态MRI联合经颅黑质超声在不同亚型帕金森病(PD)患者中的应用价值,以期为临床鉴别及治疗不同亚型PD提供参考。方法回顾性分析本院2019年8月-2022年6月期间收治的121例PD患者的病历资料,所有患者均进行多模态MRI、经颅黑质超声检查,以采用帕金森病评定量表(UPDRS)评估结果为金标准,分析多模态MRI、经颅黑质超声及联合诊断对不同亚型PD的评估价值。结果经统计,121例PD患者中,震颤型PD共73例,占比60.33%;姿势不稳/步态障碍型PD共48例,占比39.67%;以UPDRS量表评估结果为金标准,多模态MRI对PD亚型的鉴别诊断结果的一致性一般(Kappa值=0.773,P<0.001);经颅黑质超声对PD亚型的鉴别诊断结果一致性一般(Kappa值=0.620,P<0.001);联合诊断对PD亚型的鉴别诊断结果的一致性较好(Kappa值=0.827,P<0.001);绘制受试者工作特征曲线(ROC),结果显示,多模态MRI、经颅黑质超声及联合诊断的AUC分别为0.857、0.802、0.945,多模态MRI与经颅黑质超声AUC比较,差异无统计学意义(Z=1.213,P=0.225);多模态MRI与联合诊断的AUC比较,差异有统计学意义(Z=2.441,P=0.015);经颅黑质超声与联合诊断的AUC比较,差异有统计学意义(Z=3.625,P<0.001)。结论多模态MRI及经颅黑质超声单一诊断在不同亚型PD患者中的应用效果一般,二者联合诊断在不同亚型PD患者中与UPDRS量表评估结果具有高度一致性,可以作为PD患者亚型鉴别诊断的评估方法,为临床进一步治疗提供重要的参考依据。
Objective To explore the application value of multimodal MRI combined with transcranial substantia nigra ultrasound in patients with different subtypes of Parkinson's disease(PD),so as to provide reference for clinical differentiation and treatment of different subtypes of PD.Methods The medical records of 121 patients with PD admitted to our hospital from August 2019 to June 2022 were analyzed retrospectively.All patients were examined by multimodal MRI and transcranial substantia nigra ultrasound.The evaluation results of Parkinson's disease rating scale(UPDRS)were taken as the gold standard.The evaluation value of multimodal MRI,transcranial substantia nigra ultrasound and combined diagnosis for different subtypes of PD was analyzed.Results According to statistics,among 121 PD patients,73 were tremor type PD,accounting for 60.33%.There were 48 patients with postural instability/gait disorder PD,accounting for 39.67%.Based on the evaluation results of UPDRS scale as the gold standard,the consistency of multimodal MRI in the differential diagnosis of PD subtypes was general(Kappa value=0.773,P<0.001).The results of differential diagnosis of PD subtypes by transcranial substantia nigra ultrasound were generally consistent(Kappa value=0.620,P<0.001).The results of combined diagnosis for the differential diagnosis of PD subtypes were consistent(Kappa value=0.827,P<0.001).The ROC of the subjects was drawn.The results showed that the AU C of multimodal MRI,transcranial substantia nigra ultrasound and combined diagnosis were 0.857,0.802 and 0.945,respectively.There was no statistical significant difference in AU C between multimodal MRI and transcranial substantia nigra ultrasound(Z=1.213,P=0.225).The difference between multimodal MRI and AU C diagnosed jointly was statistically significant(Z=2.441,P=0.015).There was a statistically significant difference between transcranial substantia nigra ultrasound and AUC diagnosed jointly(Z=3.625,P<0.001).Conclusion The application effect of multimodal MRI and transcranial substantia nigra ultrasound single diagnosis in different subtypes of PD patients is general.The combined diagnosis of the two is highly consistent with the evaluation results of UPDRS scale in different subtypes of PD patients,which can be used as an evaluation method for the differential diagnosis of PD patients subtypes,and provide an important reference for further clinical treatment.
作者
毛攀
张迎春
丁常伟
Mao Pan;Zhang Ying-chun;Ding Chang-wei(Department of ultrasound,The Second Affiliated Hospital of Soochow University,Suzhou 215004,Jiangsu Province,China)
出处
《中国CT和MRI杂志》
2023年第8期4-6,共3页
Chinese Journal of CT and MRI
基金
苏州大学附属第二医院建设托举工程(XKTJ-TD202007)。
关键词
多模态磁共振成像
经颅黑质超声
帕金森病
亚型
Multimodal Magnetic Resonance Imaging
Transcranial Substantia Nigra Ultrasound
Parkinson's Disease
Subtype
作者简介
第一作者:毛攀,女,医师,主要研究方向:经颅超声。E-mail:ty13776192280@126.com;通讯作者:张迎春,女,主任医师,主要研究方向:经颅超声。E-mail:zyc1234@suda.edu.cn。
