Berg Daniela, Godau Jana, Walter Uwe
Center of Neurology, Department of Neurodegeneration and Hertie Institute of Clinical Brain Research, University of Tübingen, Germany.
Lancet Neurol. 2008 Nov;7(11):1044-55. doi: 10.1016/S1474-4422(08)70239-4.
Over the past 15 years the use of transcranial B-mode sonography to assess brainstem and subcortical brain structures has become an important tool for the diagnosis and differential diagnosis of various movement disorders. The most widely recognised finding for movement disorders has been an increase in echogenicity of the substantia nigra, an area of the midbrain that is affected in idiopathic Parkinson's disease (PD). This finding has enabled the reliable diagnosis of PD with high predictive values. Other sonographic features, such as hypoechogenicity of the brainstem midline and hyperechogenicity of the lentiform nucleus, might help the differential diagnosis of PD and other movement disorders. This Review provides detailed information about the advantages and limitations of this novel neuroimaging method, including guidelines for the scanning procedure and considerations on the origin of ultrasound abnormalities. We discuss the use of transcranial sonography for early and preclinical diagnosis and for differential diagnosis of PD and other movement disorders, and we compare this method with other functional neuroimaging strategies. Transcranial B-mode sonography is a reliable, non-invasive, commonly available, easily applicable, and inexpensive method, which provides new information about the morphology of the brain to help the diagnosis of various movement disorders. Thus, this neuroimaging method could be recommended for general application in the diagnosis and differential diagnosis of PD.
在过去15年中，经颅B型超声检查用于评估脑干和皮质下脑结构已成为各种运动障碍诊断和鉴别诊断的重要工具。运动障碍最广为人知的发现是黑质回声增强，黑质是中脑的一个区域，在特发性帕金森病（PD）中会受到影响。这一发现使得能够以高预测价值可靠地诊断PD。其他超声特征，如脑干中线低回声和豆状核高回声，可能有助于PD与其他运动障碍的鉴别诊断。本综述提供了有关这种新型神经影像学方法的优势和局限性的详细信息，包括扫描程序指南以及对超声异常起源的考虑。我们讨论了经颅超声在PD早期和临床前诊断以及鉴别诊断中的应用，并将该方法与其他功能性神经影像学策略进行了比较。经颅B型超声是一种可靠、无创、常用、易于应用且廉价的方法，它提供了有关脑形态的新信息，有助于各种运动障碍的诊断。因此，这种神经影像学方法可推荐用于PD诊断和鉴别诊断的一般应用。
