核磁共振成像可见血管周围间隙在预测帕金森病患者对左旋多巴反应性方面的价值

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2024-11-22 DOI:10.1016/j.ejrad.2024.111844

Zekai Chen , Die Cai , Jichun Yuan , Jiakuan Chen , Xi Zhou , Wenjie He , Jun Xia

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引用次数: 0

摘要

目的左旋多巴反应性的个体差异是医生对帕金森病（PD）患者进行个性化治疗的一项挑战。以前的研究表明，磁共振成像（MRI）可见的血管周围间隙（PVS）可能导致对左旋多巴的不完全反应。这项横断面研究共纳入了 327 名 PD 患者（中位年龄 64.0[57.0-68.0] 岁，180 名男性），他们于 2019 年至 2023 年期间在我院接受了高分辨率 T2 加权结构 MRI 检查。进行了急性左旋多巴挑战试验，以评估左旋多巴的反应性。患者被分为两组：左旋多巴反应组（MDS-UPDRS-III 降低≥ 33 %，n = 274）和无反应组（MDS-UPDRS-III 降低 < 33 %，n = 53）。我们采用定量和半定量方法评估 PD 患者的 MRI 可见 PVS，包括 PVS 数量、体积分数和视觉评分。结果左旋多巴反应组和无反应组的 PVS 数量、体积分数和视觉评分无显著差异。PVS的定量和半定量分析指标并不是左旋多巴反应性的独立预测指标。结论MRI可视PVS与左旋多巴反应性无独立关联，其在预测PD患者左旋多巴反应性方面的价值有限。

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Value of MRI-visible perivascular spaces in predicting levodopa responsiveness of patients with Parkinson’s disease

Purpose

Inter-individual difference in levodopa responsiveness is a challenge for physicians to administer personalized treatment for patients with Parkinson’s disease (PD). Previous studies demonstrated that magnetic resonance imaging (MRI)-visible perivascular spaces (PVS) might lead to an incomplete response to levodopa. This study aimed to investigate the association between MRI-visible PVS and levodopa responsiveness in patients with PD.

Methods

This cross-sectional study enrolled a total of 327 patients with PD (median age 64.0[57.0–68.0] years, 180 male) who had undergone high-resolution T2-weighted structural MRI at our hospital between 2019 and 2023. An acute levodopa challenge test was performed to evaluate levodopa responsiveness. The patients were divided into two groups: levodopa responsive (MDS-UPDRS-III reduction ≥ 33 %, n = 274) and irresponsive groups (MDS-UPDRS-III reduction < 33 %, n = 53). We employed quantitative and semi-quantitative methods to evaluate MRI-visible PVS in patients with PD, including PVS number, volume fraction, and visual score. Additionally, the imaging features of the levodopa-responsive and irresponsive groups were compared.

Results

There were no significant differences in PVS number, volume fraction, and visual score between the levodopa-responsive and −irresponsive groups. The indicators from quantitative and semi-quantitative analyses of PVS were not found to be independent predictors of levodopa responsiveness. None of the indicators from the quantitative or semi-quantitative analyses of PVS were significantly associated with poor responsiveness to levodopa treatment.

Conclusions

MRI-visible PVS are not independently associated with levodopa responsiveness, and their value in predicting levodopa responsiveness in patients with PD is limited.

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.