经颅超声诊断痉挛性斜颈  

Transcranial ultrasonography in diagnosis of cervical dystonia

作　　者：张英[1] 张迎春[1] 盛余敬[1] 陈晓芳[1] 王才善[1] 俞丽芳[1] 董智芬 罗蔚锋[2] 毛成洁[2] 熊康平[2] 杨亚萍[2] 刘春风[2] 

机构地区：[1]苏州大学附属第二医院超声科,江苏苏州215004 [2]苏州大学附属第二医院神经内科,江苏苏州215004

出　　处：《中国医学影像技术》2016年第7期1031-1034,共4页Chinese Journal of Medical Imaging Technology

基　　金：江苏省普通高校研究生实践创新计划项目(SJLX15-0578);苏州市科技发展计划项目(SYSD2015082)

摘　　要：目的 分析痉挛性斜颈患者（CD）经颅超声（TCS）的影像学特点。方法 对确诊的25例旋转型CD患者及25名性别、年龄相匹配的健康志愿者进行TCS检查。根据黑质（SN）回声强度分为Ⅰ~Ⅴ级,≥Ⅲ级则视为异常并测量强回声面积,计算强回声总面积与中脑总面积比值;根据豆状核（LN）回声强度分为Ⅰ~Ⅲ级,≥Ⅱ级则视为异常并测量其面积。结果 CD组LN回声≥Ⅱ级比例（17/25,68.00%）明显高于对照组（2/25,8.00%）,差异有统计学意义（P〈0.001）。LN强回声面积与患者的年龄、病程之间无相关性（P均〉0.05）。CD患者中LN阳性侧与患者头部旋转方向相反的比例为70.60%（12/17）,明显高于二者相同的比例（5/17,29.40%）。结论 TCS探及LN异常强回声有助于CD的临床诊断,并且LN异常强回声所在位置与CD患者头部旋转方向存在对侧性趋势。Objective To assess the features of cervical dystonia by transcranial sonography （TCS）. Methods Totally 25 cervical dystonia patients and 25 controls （control group） underwent TCS in blind manner. The echo of the substantia nigra （SN） was classified into Ⅰ-Ⅴ The echo of SN 〉Ⅲ was considered to be positively enhanced, the hyperechogenicity were measured and the hyper-substantia nigra/midbrain were calculated. The echo of the lenticular nucleus （LN） was clas- sified into Ⅰ-Ⅲ. The echo of LN ≥Ⅱwas considered to be positively enhanced and the hyperechogenicity were meas- ured. Results The ratio of the patients with LN ≥Ⅱ was greater in cervial dystonia patients （17/25, 68.00%） than in control group （2/25, 8.00%, P〈0. 001）. There were no correlation between the hyperechogenicity area of the LN and the CD patients＂ age and disease course （all P〈0.05）. In cervial dystonia patients, TCS detected more patients （12/17, 70. 60 %） with contralaterally LN hyperechogenicity than those （5/17, 29.40%） with ipsilateral LN hyperechogenicity. Conclusion According to the change of LN hyperechogenieity, TCS may provide some valuable information for clinical di- agnosis of.cervial dystonia. Furthermore, the position of LN hyperechogenicity is opposite to head rotation direction of cer- vical dystonia patient.

关 键 词：斜颈 超声检查 经颅 豆状核 

分 类 号：R746[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]