经颅超声在帕金森病诊断与黑质回声及临床特征相关性研究  

Transcranial Ultrasound in the Diagnosis of Parkinson′s Disease and the Correlation Between Substantia Nigra Echo and Clinical Features

作　　者：符颖[1] 马佳[1] 陈述[1] 常莹[1] 杨敬春[1] Fu Ying;Ma jia;Chen Shu;Chang Ying;Yang Jingchun(Department of Ultrasound.Xuanwu Hospital,Capital University of Medical Sciences,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院超声诊断科,北京市100053

出　　处：《中国超声医学杂志》2021年第8期841-844,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨经颅超声(TCS)检查中脑黑质(SN)高回声对帕金森病(PD)临床应用价值,分析其与临床分期、运动症状严重程度的相关性。方法选取145例帕金森病患者,另有96例健康成年人作为对照组,行TCS检查,测量SN高回声的面积,并计算双侧SN高回声总面积与中脑部面积比值(S/M),面积≥0.20 cm^(2)和(或)S/M≥7%时,视为阳性(SN+),分析两组SN高回声的差异;将PD组分为PDSN+组和PDSN-组,采用H-Y分期和UPDRSⅢ部分评分评定患者病情严重程度,分析两组患者临床特征的差异。结果 PD组的SN+占比、SN高回声面积、S/M比值均高于对照组;SN高回声IV级和V级组的阳性预测值高于SN高回声Ⅲ级组,有统计学差异(P<0.05);TCS诊断PD的灵敏度为61%、特异度为85%,阳性预测值为85%;PDSN+组与PDSN-组比较,患者年龄、性别、病程、UPDRSⅢ部分评分、H-Y分期均无显著性差异(P>0.05)。结论 TCS可辅助诊断PD,但SN高回声的面积和S/M比值与PD患者疾病分期和运动症状严重程度无关。Objective To investigate the clinical value of transcranial sonography(TCS) examination of the substantia nigra(SN) hyperecho in Parkinson′s disease(PD), and analyze the relationship between substantia nigra echo and clinical features. Methods A total of 145 patients with Parkinson′s disease were selected, and 96 healthy adults were selected as the control group.We measured the area of SN hyperechoic by TCS examination, and calculated S/M.Define the hyperechoic area of the substantia nigra ≥0.20 cm^(2) or S/M≥7% as positive(SN+), analyze the difference between the two groups. PD group was divided into PDSN+ and PDSN-groups. H-Y staging and scale(UPDRS) Ⅲ score was used to evaluation of Parkinson′s disease patients severity. Analyze the difference of clinical features between two groups. Results The SN+ proportion, SN hyperechoic area, and S/M ratio in PD group were all higher than those in the control group.The positive predictive value of SN grade IV and V group was higher than that of SN grade Ⅲ group, with statistical difference(P<0.05).The sensitivity, specificity and positive predictive value of TCS in PD diagnosis were 61%,85% and 85%. Patients′ age, gender, disease duration, UPDRS Ⅲ score and H-Y stage had no significant difference between PDSN+ group and PDSN-group(P>0.05). Conclusions Our results demonstrated that TCS can be used as a tool to help diagnose PD rather than a progression marker of disease stages and motor severity in PD patients.

关 键 词：经颅超声检查 中脑黑质 帕金森病 

分 类 号：R445.1[医药卫生—影像医学与核医学] R742.5[医药卫生—诊断学]