Budisic M, Trkanjec Z, Bosnjak J, Lovrencic-Huzjan A, Vukovic V, Demarin V
University Department of Neurology, Sestre Milosrdnice University Hospital, Zagreb, Croatia.
Acta Neurol Scand. 2009 Jan;119(1):17-21. doi: 10.1111/j.1600-0404.2008.01056.x. Epub 2008 Jun 10.
Until today there is no reliable test that can clearly distinguish Parkinson's disease (PD) from the essential tremor (ET). Our aim was to determine the usefulness of the transcranial sonography (TCS) in the differential diagnosis of the PD and ET as well as the interobserver reliability for this method.
Transcranial sonography of substantia nigra and clinical examination were performed on 80 PD patients, 30 ET patients, and 80 matched controls by two independent physicians.
Bilateral SN hyperechogenicity over the margin of 0.20 cm(2) was found in 91% of PD patients, 10% of healthy subjects, and in 13% patients with ET. Interobserver agreement for this method was significant (Student's t-test, P = 1.000).
Substantia nigra hyperechogenicity on TCS is a highly specific finding of PD, where in healthy individuals or in ET patients, it might correspond to an increased risk of developing PD later in life or might also be because of the impairment of nearby area of nucleus ruber in ET patients, as suggested by positron emission tomography studies. TCS may serve as a practical and sufficiently sensitive neuroimaging tool in PD diagnoses and in distinguishing it from ET; its repeatability and accuracy might add to its practical value.
直至今日，尚无可靠的检测方法能够明确区分帕金森病（PD）与特发性震颤（ET）。我们的目的是确定经颅超声检查（TCS）在PD和ET鉴别诊断中的效用以及该方法的观察者间可靠性。
由两名独立的医生对80例PD患者、30例ET患者和80例匹配的对照者进行黑质经颅超声检查和临床检查。
91%的PD患者、10%的健康受试者和13%的ET患者出现双侧黑质回声增强超过0.20 cm²。该方法的观察者间一致性显著（Student t检验，P = 1.000）。
TCS显示的黑质回声增强是PD的高度特异性表现，在健康个体或ET患者中，这可能对应于日后发生PD的风险增加，或者也可能如正电子发射断层扫描研究所示，是由于ET患者红核附近区域的损害。TCS可作为一种实用且足够敏感的神经影像学工具用于PD诊断并将其与ET区分开来；其可重复性和准确性可能会增加其实际价值。
