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目的探讨MRI在帕金森病(PD)嗅觉障碍诊断中的应用价值。方法采用Philips Achieva 1.5 T超导型全身磁共振成像仪和16通道头-颈联合线圈,对40例存在嗅觉障碍的PD患者和30例健康对照组行高分辨磁共振冠状位成像及双回波成像,分别测量嗅球体积及T2值,并进行统计学分析。结果 PD组与对照组嗅球体积分别为(10.38±4.66)mm3、(18.68±10.84)mm3,两者比较差异有统计学意义(t=6.135,P<0.001);PD组与健康对照组嗅球T2值分别为(113.22±17.06)s、(125.54±9.43)s,两者比较差异有统计学意义(t=3.461,P=0.001)。PD组H-YⅠ级与H-YⅡ级嗅球体积比较分别为(11.48±6.04)mm3、(9.83±3.12)mm3(t=1.131,P=0.265);嗅球T2值比较分别为(109.22±15.81)s、(114.05±12.57)s(t=0.866,P=0.398),差异均无统计学意义。PD组嗅球体积(左侧嗅球、右侧嗅球及两侧嗅球总体积)与病程均无明确相关性(分别为r=-0.141,P=0.393;r=-0.130,P=0.429;r=-0.139,P=0.400);PD组嗅球T2值与病程有明确相关性(r=-0.402,P=0.03)。结论PD患者嗅球体积明显减小,高分辨率MRI对嗅球体积的定量分析有助于PD嗅觉障碍的评估。PD患者嗅球T2值明显减低,反映了嗅球铁含量异常增加,并且嗅球T2值与病程有明确相关性;双回波成像嗅球铁定量分析在PD嗅觉障碍诊断中有较高的应用价值。
Objective To investigate the value of MRI in the diagnosis of Parkinson’s disease (PD) olfactory disorder. Methods Forty PD patients with olfactory dysfunction and 30 healthy controls underwent high resolution MR coronary coronal imaging and double echocardiography with a Philips Achieva 1.5 T superconducting whole body magnetic resonance imaging system and a 16-channel head-neck combined coil. Imaging, respectively, olfactory bulb volume and T2 values, and statistical analysis. Results The volumes of olfactory bulb in PD group and control group were (10.38 ± 4.66) mm3 and (18.68 ± 10.84) mm3 respectively, with significant difference between the two groups (t = 6.135, P <0.001) The values were (113.22 ± 17.06) s and (125.54 ± 9.43) s, respectively. The differences between the two groups were statistically significant (t = 3.461, P = 0.001). The volumes of H-YⅠ and H-YⅡ olfactory bulb in PD group were (11.48 ± 6.04) mm3 and (9.83 ± 3.12) mm3 respectively (t = 1.131, P = 0.265) .The T2 value of olfactory bulb were (109.22 ± 15.81) s, (114.05 ± 12.57) s (t = 0.866, P = 0.398). There was no significant difference between the two groups. There was no significant correlation between the volume of olfactory bulb and the total volume of olfactory bulb in both groups (r = -0.141, P = 0.393, r = -0.130, P = 0.429, r = 0.139, P = 0.400). There was a clear correlation between the T2 value of olfactory bulb and the course of disease in PD group (r = -0.402, P = 0.03). Conclusion The volume of olfactory bulb in patients with PD is significantly reduced. The quantitative analysis of olfactory bulb volume by high resolution MRI is helpful for the evaluation of olfactory dysfunction in patients with PD. The T2 value of olfactory bulb in patients with PD was significantly decreased, reflecting the abnormal increase of iron content in olfactory bulb and the clear correlation between T2 value of olfactory bulb and the course of disease. Quantitative analysis of olfactory bulb by double-echo imaging has a high value in the diagnosis of PD olfactory disorders.