本文選題：不寧腿綜合征 + 多回波采集的增強T2~*加權血管成像�。� 參考：《南昌大學》2014年碩士論文

【摘要】：目的：了解不寧腿綜合征(restlesslegssyndrome,RLS)患者腦鐵代謝的變化，探討RLS的發(fā)病機制及其臨床特征。 方法：采用3.0TMR系統(tǒng)對RLS患者和年齡、性別相匹配的健康志愿者分別進行常規(guī)序列、多回波采集的增強T2*加權血管成像（enhancedT2-starweightedangiography,ESWAN）序列的顱腦掃描，感興趣區(qū)包括紅核、黑質致密部、黑質網狀部、丘腦、蒼白球、殼核、尾狀核頭部、齒狀核和腦脊液共9個部位，應用以年齡為協(xié)變量的ANCOVA方法對兩組之間的腦鐵含量進行統(tǒng)計分析。 結果：35例RLS患者及35例年齡、性別相匹配的健康志愿者被納入本項研究。RLS患者和健康志愿者右側感興趣區(qū)的腦鐵含量多低于左側，，但左右兩側差異無明顯統(tǒng)計學意義（P0.05）。RLS患者腦內雙側感興趣區(qū)的鐵含量明顯低于健康對照者，尤其是紅核（F=8.372，P=0.005）、黑質致密部（F=8.741，P=0.004）、黑質網狀部（F=6.525，P=0.013）、蒼白球（F=6.275，P=0.015）、丘腦（F=5.084，P=0.027）、齒狀核（F=5.080，P=0.027）的鐵含量減少有顯著統(tǒng)計學意義，并且與不寧腿綜合征嚴重程度量表評分呈負相關。重度RLS患者腦鐵含量較輕中度RLS及健康對照者明顯降低（F=3.859,P=0.026到F=30.238,P=0.000）。血清鐵蛋白的變化與腦鐵代謝變化并不完全一致，雖然血清鐵蛋白≥45ug/l組或45ug/l組的RLS患者與健康對照組比較，雙側蒼白球（F=5.538，P=0.006）、黑質致密部（F=5.309，P=0.007）、黑質網狀部（F=3.918，P=0.025）、紅核（F=4.651，P=0.013）的鐵含量明顯降低，差異有統(tǒng)計學意義，但血清鐵蛋白≥45ug/l組與45ug/l組間比較，除蒼白球外，所有感興趣區(qū)的腦鐵含量差異無顯著性（P0.05）。ESWAN技術對于腦鐵含量的檢測具有較高的診斷價值，丘腦區(qū)ROC曲線下面積為0.949，其敏感性和特異性分別為100%、76.2%。結論：RLS患者腦鐵含量明顯降低，以紅核、黑質、蒼白球最為明顯，病情嚴重時腦鐵代謝異常的范圍更廣，并且RLS患者的腦鐵含量與不寧腿綜合征嚴重程度量表評分呈負相關。血清鐵蛋白測定在RLS診治中的價值需進一步評估。ESWAN技術有可能成為RLS患者臨床評估的重要方法。
[Abstract]:Objective: to investigate the changes of brain iron metabolism in patients with restless legs syndrome (RLS) and to explore the pathogenesis and clinical features of RLS. Methods: a 3.0TMR system was used to scan the brain of RLS patients and healthy volunteers matched by age and sex. The enhanced T2 * weighted angiography (ESWAN) sequences were obtained by multi-echo imaging. The regions of interest included the nucleus erythema and the dense part of substantia nigra. The brain iron content in the substantia nigra reticular part, thalamus, globus pallidus, putamen nucleus, caudate nucleus head, dentate nucleus and cerebrospinal fluid was analyzed by ANCOVA method. Results in this study, 35 RLS patients with RLS and 35 healthy volunteers with age and sex matched were included in this study. The brain iron content in the right region of interest of RLS patients and healthy volunteers was lower than that in the left side. However, there was no significant difference between left and right sides (P0.05). The iron content in bilateral regions of interest in RLS patients was significantly lower than that in healthy controls. In particular, the reduction of iron content in the nucleus rubrum (FV 8.372), the dense part of the substantia nigra (P0. 004), the reticular part of the substantia nigra (FN 6. 525), the globus pallidus (FN 6. 275), the thalamus (FN 5. 084P0. 027) and the dentate nucleus (F5. 080 P0. 027) had significant statistical significance. The content of brain iron in patients with severe RLS was significantly lower than that in patients with mild and moderate RLS and healthy controls (F0. 859%, P < 0. 026, F = 30. 238, P < 0. 000). The changes of serum ferritin were not consistent with the changes of brain iron metabolism, although the serum ferritin 鈮

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