PD全脑结构MR形态学分析及静息态功能磁共振研究

Morphological Analysis of MR in PD Whole Brain Structure and Resting State fMR Study

摘要: 目的：探讨基于磁共振成像(MRI)的全脑定量评价技术在帕金森病诊断中的价值。方法：回顾性分析2022年1月至2024年12月在我院就诊的120例患者，包括帕金森默病(PD) 40例、轻度认知障碍(MCI) 40例及年轻健康体检病例作为对照(HC) 40例。采用1.5T、3.0T MRI获取T1加权图像，使用FreeSurfer 7.2进行全脑体积、灰质(GM)、白质(WM)及海马体积自动分割，结合临床认知量表(MMSE、MoCA)进行相关性分析。结果：PD组全脑体积较HC组减少12.3% (p < 0.001)，海马体积差异最显著(PD vs HC: −28.5%, p < 0.001)。MCI组灰质体积与MoCA评分呈正相关(r = 0.62, p = 0.002)。联合海马体积与颞叶皮层厚度可提高AD诊断敏感度至89.7% (AUC = 0.92)。结论：全脑影像定量分析可有效鉴别PD、MCI与正常衰老，为临床及时干预治疗提供影像学指导，具有重要临床转化潜力。

Abstract: Objective: To explore the value of whole-brain quantitative evaluation technology based on magnetic resonance imaging (MRI) in the diagnosis of Parkinson’s disease. Methods: A retrospective analysis of 120 patients who visited our hospital from January 2022 to December 2024, including 40 Parkinson’s disease (PD), 40 mild cognitive impairment (MCI) and 40 young health examination cases as control (HC). T1-weighted images were obtained by 1.5T and 3.0TMRI, and automatic segmentation of whole brain volume, gray matter (GM), white matter (WM) and hippocampal volume was performed using FreeSurfer7.2, and correlation analysis was performed in combination with clinical cognitive scales (MMSE, MoCA). Results: The whole brain volume in the PD group was 12.3% lower than that in the HC group (p < 0.001), and the hippocampus volume difference was the most significant (PD vs HC: −28.5%, p < 0.001). The gray matter volume in the MCI group was positively correlated with the MoCA score (r = 0.62, p = 0.002). Combining hippocampal volume and temporal cortex thickness can improve AD diagnostic sensitivity to 89.7% (AUC = 0.92). Conclusion: Quantitative analysis of whole-brain imaging can effectively distinguish PD, MCI from normal aging, provide imaging guidance for timely clinical intervention and treatment, and has important clinical transformation potential.