Walter U, Dressler D, Wolters A, Probst T, Grossmann A, Benecke R
Department of Neurology, University of Rostock, Gehlsheimer Str. 20, D-18147 Rostock, Germany.
Neurology. 2004 Aug 10;63(3):504-9. doi: 10.1212/01.wnl.0000133006.17909.32.
To study the use of brain parenchyma sonography (BPS) in discriminating between patients with corticobasal degeneration (CBD) and progressive supranuclear palsy (PSP).
Thirteen patients with PSP and eight with CBD were studied with BPS according to a standardized protocol.
Seven (88%) of the eight CBD patients showed marked hyperechogenicity of the substantia nigra (SN) but none of eleven PSP patients (Mann-Whitney U test, p < 0.001). This finding indicated CBD with a positive predictive value of 100%. Marked dilatation of the third ventricle (width > 10 mm) was found in 10 (83%) of 12 PSP patients, but in none of the CBD patients (p < 0.005). BPS measurements of ventricle widths closely matched MRI measurements (Pearson correlation, r = 0.90, p < 0.001). The presence of at least one of the BPS findings 1) marked SN hyperechogenicity and 2) third-ventricle width < 10 mm indicated CBD with a sensitivity of 100%, a specificity of 83%, and a positive predictive value of 80%. Other BPS findings such as echogenicity of lentiform and caudate nuclei and widths of the frontal horns did not discriminate between CBD and PSP. One PSP patient could not be assessed because of insufficient acoustic temporal bone windows.
Substantia nigra hyperechogenicity, reported earlier as characteristic brain parenchyma sonography finding in idiopathic Parkinson disease, is also typical for corticobasal degeneration.
研究脑实质超声检查（BPS）在鉴别皮质基底节变性（CBD）和进行性核上性麻痹（PSP）患者中的应用。
按照标准化方案，对13例PSP患者和8例CBD患者进行BPS检查。
8例CBD患者中有7例（88%）黑质显示明显高回声，但11例PSP患者中无1例如此（曼-惠特尼U检验，p<0.001）。这一发现提示CBD，其阳性预测值为100%。12例PSP患者中有10例（83%）第三脑室明显扩张（宽度>10mm），但CBD患者中无1例如此（p<0.005）。BPS测量的脑室宽度与MRI测量结果密切匹配（皮尔逊相关性，r=0.90，p<0.001）。BPS检查结果中至少出现以下1项：1）黑质明显高回声和2）第三脑室宽度<10mm，提示CBD，其敏感性为100%，特异性为83%，阳性预测值为80%。其他BPS检查结果，如豆状核和尾状核的回声以及额角宽度，在CBD和PSP之间无鉴别意义。1例PSP患者因颞骨声窗不足无法评估。
黑质高回声，先前报道为特发性帕金森病典型的脑实质超声检查表现，也是皮质基底节变性的典型表现。
