Diagnostic value of combined magnetic resonance imaging techniques in the evaluation of Parkinson disease

Qing Cao; Xiaowei Han; Dongping Tang; Hao Qian; Kun Yan; Xun Shi; Yaowei Li; Jiangong Zhang

doi:10.21037/qims-23-87

Diagnostic value of combined magnetic resonance imaging techniques in the evaluation of Parkinson disease

Quant Imaging Med Surg. 2023 Oct 1;13(10):6503-6516. doi: 10.21037/qims-23-87. Epub 2023 Aug 18.

Authors

Qing Cao^#¹, Xiaowei Han^#², Dongping Tang³, Hao Qian⁴, Kun Yan⁴, Xun Shi⁵, Yaowei Li^#¹, Jiangong Zhang^#⁵

Affiliations

¹ Department of Radiology, Guangzhou Xinhai Hospital, Guangzhou, China.
² Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
³ Department of Science and Education, Guangzhou Xinhai Hospital, Guangzhou, China.
⁴ Department of Neurology, Guangzhou Xinhai Hospital, Guangzhou, China.
⁵ Department of Nuclear Medicine, The First People's Hospital of Yancheng, The Fourth Affiliated Hospital of Nantong University, Yancheng, China.

^# Contributed equally.

Abstract

Background: The incidence of Parkinson disease (PD) has been increasing each year. The development of new magnetic resonance imaging (MRI) technology can help understand its pathogenesis and identify more effective imaging-based biological indicators.

Methods: The clinical and MRI imaging data of 40 patients with PD and 40 healthy controls were analyzed. All participants underwent susceptibility-weighted imaging (SWI), neuromelanin-sensitive magnetic resonance imaging (NM-MRI), and T2*mapping sequence examination. The diagnostic value of single and combined multiparameter indicators was analyzed using the receiver operating characteristic curve.

Results: Compared with the healthy control group, the PD group showed significant differences in the disappearance of bilateral "swallow tail sign", the distribution volume of melanocytes in the substantia nigra and the smaller volume in the bilateral substantia nigra, the maximum signal of the locus coeruleus and the smaller and average volume in the bilateral substantia nigra, and the values of T2* and R2* in the bilateral substantia nigra (P<0.01). The maximum and smaller value and the average value of the bilateral locus coeruleus signal were negatively correlated with the disease course duration (P<0.05), and the smaller distribution volume of the melanin neurons in the bilateral substantia nigra was negatively correlated with Hoehn and Yahr (H-Y) grade (P<0.05). In the joint diagnosis with multiple indicators, some composite parameters were found to be negatively correlated with H-Y grading (P<0.05), while others were negatively correlated with disease course duration (P<0.05). Joint use of multiple parameter indicators greatly improved diagnostic efficacy [area under the curve (AUC) =0.958].

Conclusions: The distribution volume of melanin in substantia nigra and the maximum value of locus coeruleus signal may be the biological imaging indicators for the early diagnosis, severity, and follow-up evaluation of PD. Compared with a single indicator, composite indicators used in combination with multiple techniques have a significantly better diagnostic efficacy for PD.

Keywords: Parkinson disease (PD); diagnostic efficacy; neuromelanin-sensitive magnetic resonance imaging (NM-MRI); receiver operating characteristic curve; susceptibility-weighted imaging (SWI).