發(fā)布時間：2018-05-14 13:29

  本文選題：帕金森病 + 嗅覺障礙��； 參考：《蘇州大學(xué)》2014年碩士論文

【摘要】：第一部分高分辨磁共振成像在帕金森病嗅球體積及嗅溝深度測量中的應(yīng)用 目的：通過對嗅球及嗅溝進行高分辨磁共振成像，探討磁共振成像測量嗅球體積及嗅溝深度對帕金森病嗅覺障礙評估的臨床應(yīng)用價值。 方法：采用Philips Achieva1.5T超導(dǎo)型全身磁共振成像儀和16通道頭-頸聯(lián)合線圈，對40例存在嗅覺障礙的PD患者和30例正常對照組進行高分辨磁共振冠狀位成像，分別測量嗅球體積及嗅溝深度，并進行統(tǒng)計學(xué)分析。PD組與對照組之間嗅球體積及嗅溝深度比較采用兩獨立樣本t檢驗，，PD組嗅球體積與病程的關(guān)系采用控制年齡的偏相關(guān)性分析。 結(jié)果：PD組與對照組嗅球體積分別為10.38±4.66mm3、18.68±10.84mm3，兩者比較差異有統(tǒng)計學(xué)意義（t=6.135, P 0.001）；PD組與對照組嗅溝深度分別為10.97±1.826mm、11.55±1.89mm，兩者比較差異無統(tǒng)計學(xué)意義（t=1.296, P=0.199）。PD組H-Y I級與H-Y II級嗅球體積（分別為11.48±6.04mm3、9.83±3.12mm3; t=1.131, P=0.265）及嗅溝深度（分別為11.04±2.15mm、10.92±1.59mm; t=0.224, P=0.824）分別比較差異均無統(tǒng)計學(xué)意義。PD組嗅球體積（左側(cè)嗅球、右側(cè)嗅球及兩側(cè)嗅球總體積）與病程均無明確相關(guān)性（分別為r=-0.141, P=0.393; r=-0.130, P=0.429; r=-0.139,P=0.400）。 結(jié)論：帕金森病患者嗅球體積明顯減小，高分辨磁共振成像對嗅球體積的定量分析有助于帕金森病嗅覺障礙的評估。 第二部分磁共振雙回波序列T2值評估帕金森病嗅球鐵含量的初步研究 目的：采用雙回波序列對嗅球進行T2值的定量分析，探討雙回波技術(shù)評價嗅球鐵含量的可行性，以及帕金森病嗅球鐵含量的變化特點，及其在帕金森病嗅覺障礙診斷中的價值。 方法：采用Philips Achieva1.5T超導(dǎo)型全身磁共振成像儀和16通道頭-頸聯(lián)合線圈，對30例存在嗅覺障礙的PD患者及30例正常對照組進行雙回波序列冠狀位掃描，并測量嗅球雙回波序列的T2值。PD組與對照組之間嗅球T2值比較采用兩獨立樣本t檢驗；PD組嗅球T2值與病程相關(guān)性采用控制年齡的偏相關(guān)分析。 結(jié)果：PD組與正常對照組嗅球T2值分別為113.22±17.06s、125.54±9.43s，兩者比較差異有統(tǒng)計學(xué)意義（t=3.461, P=0.001）；PD組病程與嗅球T2值有明確相關(guān)性（r=-0.402, P=0.03）；PD組H-Y I級與H-Y II級嗅球T2值分別為109.22±15.81s、114.05±12.57s，兩者比較差異無統(tǒng)計學(xué)意義（t=0.866, P=0.398）。 結(jié)論：帕金森病患者嗅球T2值明顯減低，反映嗅球鐵含量異常增加，并且嗅球T2值與病程有明確相關(guān)性。雙回波成像嗅球鐵定量分析在帕金森病嗅覺障礙診斷中有較高的應(yīng)用價值。 第三部分磁共振彌散張量成像在帕金森病嗅覺障礙診斷中的應(yīng)用價值研究 目的：應(yīng)用磁共振彌散張量成像（DTI）測量嗅覺相關(guān)中樞結(jié)構(gòu)的FA值，探討FA值評價帕金森病嗅覺相關(guān)中樞功能狀態(tài)的臨床應(yīng)用價值。 方法：采用Philips Achieva1.5T超導(dǎo)型全身磁共振成像儀和16通道頭-頸聯(lián)合線圈，對24例存在嗅覺障礙的PD患者及30例正常對照組進行顱腦15個方向的DTI掃描，分別測量直回、海馬及海馬旁回、梨狀皮質(zhì)及杏仁核周圍皮質(zhì)（PCA）的FA值，并生成纖維束走行圖。PD組與對照組之間的FA值比較采用兩獨立樣本t檢驗；PD組及對照組左右兩側(cè)嗅覺相關(guān)中樞結(jié)構(gòu)的FA值比較采用配對樣本t檢驗。 結(jié)果：PD組與對照組PCA區(qū)FA值分別為0.396±0.045、0.463±0.037，兩者比較差異有統(tǒng)計學(xué)意義（t=6.059, P 0.001）；PD組ROI纖維束數(shù)目明顯少于對照組。PD組與對照組直回FA值（分別為0.466±0.038、0.474±0.043; t=1.133, P=0.263）、海馬及海馬旁回FA值（分別為0.424±0.026、0.434±0.029; t=1.289, P=0.203）比較差異均無統(tǒng)計學(xué)意義。PD組左右兩側(cè)嗅覺相關(guān)中樞結(jié)構(gòu)FA值（直回0.466±0.038、0.459±0.038, t=0.639、P=0.526;海馬及海馬旁回0.424±0.026、0.433±0.031, t=1.124、P=0.267; PCA0.396±0.045、0.405±0.042, t=0.743、P=0.461）及對照組左右兩側(cè)嗅覺相關(guān)中樞結(jié)構(gòu)FA值（直回0.474±0.043、0.478±0.075, t=0.234、P=0.815;海馬及海馬旁回0.434±0.029、0.450±0.034, t=1.990、P=0.052; PCA0.463±0.037、0.465±0.048,t=0.168、P=0.867）分別比較，差異均無統(tǒng)計學(xué)意義。 結(jié)論：帕金森病患者感興趣區(qū)的纖維束數(shù)目減少，PCA區(qū)FA值明顯減低。磁共振彌散張量成像可在體評估PD嗅覺相關(guān)中樞的功能狀態(tài)，對PD的早期診斷具有一定的參考價值。
[Abstract]:Application of the first partial high resolution magnetic resonance imaging in the measurement of olfactory bulb volume and olfactory groove depth in Parkinson ' s disease

Objective : To evaluate the clinical application value of olfactory bulb volume and olfactory groove depth on olfactory dysfunction in patients with Parkinson ' s disease by high resolution magnetic resonance imaging of olfactory bulb and olfactory groove .

Methods : 40 cases of PD patients with olfactory disorder and 30 normal controls were imaged with high resolution magnetic resonance coronal images by Philips detachable eva1.5T superconducting whole - body magnetic resonance imager and 16 - channel head - neck combined coil . The olfactory bulb volume and olfactory groove depth were measured respectively . The olfactory bulb volume and the depth of olfactory groove were compared between PD and control groups .

Results : The volume of olfactory bulb in PD group and control group were 10.38 鹵 4.66mm3 and 18.68 鹵 10.84mm3 , respectively . There was significant difference between them ( t = 6.135 , P 0.001 ) .
The depth of olfactory sulcus in PD group and control group were 10.97 鹵 1.826mm and 11.55 鹵 1.89mm , respectively . There was no significant difference between PD group and control group ( t = 1.296 , P = 0.199 ) . There was no statistical difference between PD group H - Y grade I and H - Y grade II olfactory bulb volume ( 11.48 鹵 6.04mm3 , 9.83 鹵 3.12 mm3 , t = 1.131 , P = 0.265 ) and olfactory groove depth ( 11.04 鹵 2.15mm , 10.92 鹵 1.59mm , t = 0.224 , P = 0.824 ) .

Conclusion : The volume of olfactory bulb in patients with Parkinson ' s disease is obviously reduced , and the quantitative analysis of olfactory bulb volume by high resolution magnetic resonance imaging can help to evaluate the olfactory dysfunction of Parkinson ' s disease .

A preliminary study on the evaluation of iron content in the olfactory bulb of Parkinson ' s disease by the second partial magnetic resonance double echo sequence T2

Objective : To explore the feasibility of double echo technique to evaluate the content of olfactory bulb iron and the change of olfactory bulb iron content in Parkinson ' s disease and its value in the diagnosis of olfactory disorder of Parkinson ' s disease by quantitative analysis of T2 value of olfactory bulb by double echo sequence .

Methods : 30 cases of PD patients with olfactory disorder and 30 normal controls were scanned with double echo sequence coronal images by Philips detachable eva1.5T superconducting whole - body magnetic resonance imager and 16 - channel head - neck combined coil . The T2 values of olfactory bulb double echo sequence were measured .
Correlation analysis of control age was adopted in PD group olfactory bulb T2 value and course correlation .

Results : The T2 values of olfactory bulb in PD group and normal control group were 11.22 鹵 17.06s and 125.54 鹵 9.43s , respectively . There was significant difference between the two groups ( t = 3.461 , P = 0.001 ) .
There was a clear correlation between the PD group and the value of the olfactory bulb T2 ( r = - 0.402 , P = 0.03 ) .
In PD group , the values of H - Y I and H - Y II olfactory bulb T2 were 109.22 鹵 15.81s and 114.5 鹵 12.57s , respectively . There was no significant difference between them ( t = 0.866 , P = 0.398 ) .

Conclusion : The value of olfactory bulb T2 in patients with Parkinson ' s disease is significantly decreased , which reflects the abnormal increase of olfactory bulb iron content and the relationship between the value of olfactory bulb T2 and the course of disease .

Application of the third partial magnetic resonance diffusion tensor imaging in the diagnosis of olfactory dysfunction in Parkinson ' s disease

Objective : To evaluate the value of FA in evaluating the functional status of olfactory related central nervous system in patients with Parkinson ' s disease by using diffusion tensor imaging ( DTI ) .

Methods : Twenty - four PD patients with olfactory dysfunction and 30 normal controls underwent DTI scanning in 15 directions . The FA values of direct gyrus , hippocampus and parahippocampal gyrus , pear - like cortex and peripheral cortex ( PCA ) were measured .
The FA values of olfactory - related central structures on both sides of PD and control groups were compared with paired t - test .

Results : The FA values of PCA in PD group and control group were 0.396 鹵 0.045 and 0.463 鹵 0.037 , respectively . There was significant difference between the two groups ( t = 6.059 , P 0.001 ) .
There was no significant difference between PD group and control group . The FA values of olfactory - related central structures ( 0.446 鹵 0.028 , 0.474 鹵 0.043 , t = 1.133 , P = 0.629 , t = 1.124 , P = 0.267 , P = 0.641 , 0.405 鹵 0.042 , 0.450 鹵 0.034 , 0.465 鹵 0.048 , t = 0.168 , P = 0.867 ) on both sides of PD group were significantly lower than those in control group .

Conclusion : The number of fiber bundles in the region of interest of Parkinson ' s disease is decreased and the FA value in PCA region is obviously reduced . MR diffusion tensor imaging can be used to evaluate the functional status of PD olfactory related central nervous system in vivo , and has certain reference value to the early diagnosis of PD .

【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R445.2;R742.5

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