经颅超声影像诊断帕金森病的初步临床应用  

Preliminary Application of Transcranial Ultrasonography in Parkinson's Disease

作　　者：刘禧[1] 王佳[1] 孙嗣国[1] 杨一林[1] 常崇旺[1] 张莉[1] 许磊[1] 段云友[1] 

机构地区：[1]解放军第四军医大学唐都医院超声科,西安市710038

出　　处：《中国超声医学杂志》2013年第7期577-580,共4页Chinese Journal of Ultrasound in Medicine

基　　金：陕西省社发攻关课题资助(No.2011K14-07-11)

摘　　要：目的本研究旨在评价经颅超声影像诊断帕金森病(PD)的临床应用价值。方法收集临床疑似PD患者72例及对照组50例,经颅超声探查患者中脑(MB)的黑质区是否有片状增强回声(SNH),描记MB及SNH面积,计算SNH/MB;随访行立体定向脑深部电刺激术的患者17例,观察电极植入形态和位置。结果 54例患者(76%)出现明显SNH,其中39例诊断为PD,SNH面积(0.33±0.07)cm^2,SNH/MB为9%～19%。15例非PD患者SNH面积(0.30±0.07)cm^2,SNH/MB为8%～19%。与对照组相比,均差别显著(P<O.001),PD与非PD相比,SNH无显著性差异。随访脑立体定向术后的患者,可清晰显示微电极回声及位置。结论经颅超声影像可显示PD患者中脑异常增大的片状强回声区,对PD的诊断及术后随访有临床应用价值。Objective The purpose of this study is to apply the transcranial ultrasonography in a group of pa-tients with doubted diagnosis of Parkinson＇s disease （PD） and evaluate the potential role of TCCS in clinical work. Methods Seventy-two individuals suspected of PD were selected to be examined by ultrasonography. The control group was 50 normal volunteers randomly selected and age matched. By transcranial ultrasonography, images of mid-brain （MB） and substantia nigra area hyperechoic （SNH） were observed carefully and traced so that the area was measured. The ratio of SNH/MB were calculated and analyzed. Seventeen PD patients treated by stereotactic deep brain stimulation surgery were followed up. The shape and position of implanted electrodes were observed. Results 54 out of 72 patients （760//00） were found hyperechoic blot in SN. Within the 54 patients, 39 patients with the clinical certified diagnosis of PD. The SNH hyperechoic area of PD patient is （0.33±0.07） cm^2 and SNH/MB ratio is from 9% to 19% ; SNH of non-PD patients is （0.30±0.07） cm^2 and SNH/MB is 8% to 19%. SNH image of control group is only a thin cord or slightly punctuate hyperechoic. There is a significant difference between PD patients and control group （P〈0. 001）. Seventeen patients treated by stereotactic deep brain electrical stimulation surgery were followed up. The micro-electrode needle could be detected clearly as hyperechoic linear near SN area, with which the original SNH area was partly covered. Those patient＇s symptoms were improved significantly. Conclusions It is concluded that transcranial ultrasound may consistently display abnormal increase and enlarged hyperechoic in substantia nigra area in PD patients. It would be great value in diagnosis and postoperative follow-up study of PD.

关 键 词：超声影像 帕金森病 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]