脑黑质经颅超声在特发性震颤与帕金森病鉴别诊断中的应用研究  

Application of Transcranial Sonography in the Diagnosis of Essential Tremor and Parkinson’s Disease

作　　者：张艳[1] 黄辉[1] 孙珂 Zhang Yan;Huang Hui;Sun Ke(Department of Internal Neurology,Huaibei People’s Hospital,Huaibei,Anhui 235000,China;Department of Ultrasound,Huaibei People’s Hospital,Huaibei,Anhui 235000,China)

机构地区：[1]淮北市人民医院神经内科,安徽省淮北市235000 [2]淮北市人民医院超声科,安徽省淮北市235000

出　　处：《中国超声医学杂志》2023年第5期486-489,共4页Chinese Journal of Ultrasound in Medicine

基　　金：安徽省卫生健康委科研项目(No.AHWJ2021b083)。

摘　　要：目的 探讨脑黑质经颅超声(TCS)在特发性震颤(ET)与帕金森病(PD)鉴别诊断中的应用成效。方法 回顾性选取60例ET及PD患者(ET组21例,PD组39例)。研究对象均接受脑黑质TCS检查,对比各组的脑黑质回声强度分布、脑黑质高回声率、脑黑质高回声面积及双侧脑黑质高回声总面积/脑黑质总面积(S/M)比值,分析脑黑质高回声面积及S/M值对PD的诊断效能。结果 PD组脑黑质高回声率显著高于ET组,左侧、右侧、较大侧、双侧脑黑质高回声面积及S/M值均显著高于ET组(P<0.05)。脑黑质高回声面积(左侧、右侧、较大侧及双侧)、S/M值诊断PD的曲线下面积(AUC)依次为0.798、0.785、0.862、0.865和0.857,较大侧脑黑质高回声面积对PD的诊断效能优于左侧和右侧(P<0.05)。结论 脑黑质TCS检查可发现脑黑质异常强回声,帮助临床从震颤人群中有效鉴别出ET和PD,提高震颤患者病因诊断的诊断准确度。Objective To explore the effect of midbrain substantia nigra transcranial sonography(TCS)in the differential diagnosis of essential tremor(ET)and Parkinson’s disease(PD).Methods 60patients with ET and PD(21in ET group and 39in PD group)were selected retrospectively.All subjects were examined by TCS of substantia nigra in the midbrain.The distribution of echo intensity in the substantia nigra of the midbrain,the high echo rate of SN in the substantia nigra,the high echo area in the substantia nigra of the midbrain and the ratio of the total area of high echo in the substantia nigra of both sides to the total area of the midbrain(S/M)were compared in each group,and the diagnostic efficacy of the high echo area of the substantia nigra of the midbrain and the S/M value on PD was analyzed.Results The hyperechoic rate of SN in substantia nigra of PD group was significantly higher than that in ET group,and the hyperechoic area and S/M value of left,right,larger and bilateral substantia nigra were significantly higher than those in ET group(P<0.05).The hyperechoic area of SN in substantia nigra(left,right,larger and bilateral)and the area under curve(AUC)of S/M value for diagnosis of PD were 0.798,0.785,0.862,0.865and 0.857,respectively.Conclusions TCS examination of substantia nigra in the midbrain can find abnormal strong echo of midbrain substantia nigra,which can help the clinical teffectively distinguish ET and PD from patients with tremor,and improve the diagnostic accuracy of the etiology of the patients with tremor.

关 键 词：脑黑质 经颅超声检查 特发性震颤 帕金森病 诊断 

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]