【摘要】 目的：探讨功能磁共振成像对帕金森病（Parkinson’s disease,PD）伴发轻度认知功能障碍的早期诊断价值。方法 ：纳入2020年3月—2021年12月于我院就诊的47例PD伴发轻度认知功能障碍患者为轻度组，另纳入66认知功能正常的PD患者为正常组。收集所有PD患者磁共振弥散张量成像（Diffusion tensor imaging,DTI）及磁敏感加权成像（Susceptibility-weighted imaging,SWI）图像特征，分析功能磁共振成像对PD伴发轻度认知功能障碍的早期诊断价值。结果：两组患者DTI、SWI图像特征比较，正常组额叶白质、顶叶白质、颞叶白质、枕叶白质、前扣带束、后扣带束、胼胝体膝部、胼胝体压部各向异性分数（Fractional anisotropy,FA）值高于轻度组（P<0.001、P<0.001、P<0.001、P<0.001、P=0.010、P=0.047、P<0.001、P=0.023），黑质磁化率成像（Quantitative susceptibility mapping,QSM）值低于轻度组（P<0.001）。多因素Logistic回归分析显示额叶白质（OR=0.121）、顶叶白质（OR=0.168）、颞叶白质（OR=0.184）、枕叶白质（OR=0.099）、前扣带束（OR=0.207）、后扣带束（OR=0.179）、胼胝体膝部（OR=0.317）、胼胝体压部FA值（OR=0.223）及黒质QSM值（OR=1.020）是PD伴早期轻度认知功能障碍的诊断因子（P<0.05），基于此建立的诊断模型诊断PD伴早期轻度认知功能障碍的AUC为0.916，敏感度为87.23%，特异度为95.45%。结论：功能磁共振成像的DTI及SWI图像特征可用于PD伴发轻度认知功能障碍的早期诊断。更多还原

【Abstract】 Objective: To explore the value of functional magnetic resonance imaging in the early diagnosis of Parkinson’s disease(PD) with mild cognitive impairment. Methods: Forty-seven PD patients with mild cognitive impairment who were treated in our hospital from March 2020 to December 2021 were included as the mild group, and 66 PD patients with normal cognitive function were included as the normal group. All PD patients underwent diffusion tensor imaging(DTI) and susceptibilityweighted imaging(SWI) to evaluate cognitive dysfunction. Results: The DTI and SWI showed that the fractional anisotropy(FA)values of the frontal white matter, parietal white matter, temporal white matter, occipital white matter, anterior cingulum, posterior cingulum, genu of the corpus callosum, and splenium of the corpus callosum were significantly higher in the normal group than in the mild group, while the quantitative susceptibility mapping(QSM) values of the substantia nigra were significantly lower in the normal group than in the mild group(P<0.05). Multivariate Logistic regression analysis revealed that the FA values of the frontal white matter(OR=0.121), parietal white matter(OR=0.168), temporal white matter(OR=0.184), occipital white matter(OR=0.099), anterior cingulum(OR=0.207), posterior cingulum(OR=0.179), genu of the corpus callosum(OR=0.317), splenium of the corpus callosum(OR=0.223), and the QSM value of the substantia nigra(OR=1.020) were diagnostic factors for early PD with mild cognitive impairment(P<0.05). The diagnostic model established based on these parameters achieved an area under the curve(AUC) of 0.916, with a specificity of 95.45% and a sensitivity of 87.23% for identifying early PD with mild cognitive impairment. Conclusion: DTI and SWI can be used for the early diagnosis of PD with mild cognitive impairment.更多还原