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目的 探讨扩散峰度成像(diffusion kurtosis imaging,DKI)各参数值在不同运动障碍亚型帕金森病(Parkinson’s disease,PD)患者及正常对照组灰质核团的变化及不同运动障碍亚型临床异质性表现.方法 对97例PD患者及83例正常对照组进行常规序列及DKI序列检查. PD患者根据运动症状分为两型:姿势步态异常型( postural instability and gait disorder,PIGD;n=57例)及震颤型(tremor dominant,TD;n=40例).经图像后处理生成各向异性分数( FA)图、平均弥散率( MD)图 、横向弥散率(Da)图、径向弥散率(Dr)图、平均弥散峰度(MK)图、横向峰度( Ka)图和径向峰度( Kr)图,分别测量左、右侧红核、黑质网状带、黑质致密带、尾状核头、壳核、苍白球和丘脑的各参数值,并对所得数据进行统计分析.结果 (1)TD型PD患者的首发症状以震颤为主;而PIGD型PD患者的首发症状以强直、运动迟缓及步态障碍为主;TD型的MMSE评分较PIGD型高(P=0. 019);且改良Hoehn-Yahr病情分级较轻(P0. 05). (2)与正常对照组对比,①PIGD型及TD型各核团MD值、Da值及Dr值均明显降低,而Ka值升高,均差异有统计学意义(均 P0. 05).结论 TD型与PIGD型PD在首发疾病、典型症状方面具有明显的异质性. DKI参数可以较敏感地量化不同运动障碍亚型PD患者灰质核团微观结构的变化.“,”Objective To investigate the difference in the microstructure of gray matter nucleus in different movement subtypes of Parkinson’s disease (PD) by diffusion kurtosis imaging ( DKI) technique, and to analyze the correlation with clinical manifestations. Methods Ninety-seven patients with PD and 83 healthy controls performed conventional MRI sequence and DKI sequence scan. The PD patients were classi-fied into gait disorder subtype (PIGD,n=57) and tremor dominant subtype (TD,n=40)subtypes according to motor symptoms. Fractional anisotropy (FA),mean diffusivity (MD),axial diffusivity (Da),radial diffu-sivity(Dr),mean kurtosis (MK),axial kurtosis (Ka) and radial kurtosis (Dr) maps and data were genera-ted by software after processing. DKI was performed for all subjects and data was collected from different brain regions in both hemispheres,including red nucleus(RN),substantia nigra pars reticulate( SNr),sub-stantia nigra pars compacta(SNc),putamen(PUT),globus pallidus(GP),head of caudate nucleus (CN)and thalamus(THA). Results TD showed a higher MMSE score(P=0. 019),but lower modified Hoehn-Yahr score than that in PIGD (P0. 05) in TD and PIGD. Conclusion There is heterogeneity of clinical symptoms between these two subgroups of PD. DKI can quantify the microstructural changes of grey matter nucleus in different type PD patient.