Bártová Petra, Skoloudík David, Ressner Pavel, Langová Katerina, Herzig Roman, Kanovsky Petr
Department of Neurology, University Hospital Ostrava, Listopadu 1790, CZ-708 52 Ostrava, Czech Republic.
J Ultrasound Med. 2010 Jan;29(1):37-42. doi: 10.7863/jum.2010.29.1.37.
The aim of this study was to assess the correlation between substantia nigra (SN) echogenic features and area and the clinical symptoms in patients with Parkinson disease (PD).
Clinical examinations and transcranial sonographic evaluations of the SN were performed in 115 consecutive patients with PD. The presence of tremors, rigidity, bradykinesia, gait disorders, speech disorders, and hypomimia was evaluated according to the motor portion of the Unified Parkinson Disease Rating Scale. The Mann-Whitney U test, the Kruskal-Wallis test, analysis of variance, and multivariate analysis were applied when assessing statistical significance.
An enlarged and hyperechoic SN existed in 84.0% of patients with bilateral rigidity but in only 70.6% of patients with unilateral rigidity (P < .05). Similarly, 85.0% of patients with bilateral bradykinesia in comparison with 65.7% of patients with unilateral bradykinesia had an enlarged and hyperechoic SN (P < .05). A significant correlation was shown between the SN echogenicity and area (r = 0.705; P < .01). Conclusions. An enlarged and hyperechoic SN seems to be a marker of structural involvement of the SN in patients with PD. This structural involvement is expressed more in patients with bilateral rigidity and bradykinesia.
本研究旨在评估帕金森病（PD）患者黑质（SN）回声特征及面积与临床症状之间的相关性。
对115例连续的PD患者进行了临床检查及SN的经颅超声评估。根据统一帕金森病评定量表的运动部分评估震颤、强直、运动迟缓、步态障碍、言语障碍和表情减少的存在情况。在评估统计学意义时应用了曼-惠特尼U检验、克鲁斯卡尔-沃利斯检验、方差分析和多变量分析。
双侧强直患者中84.0%存在SN增大且回声增强，而单侧强直患者中仅70.6%存在这种情况（P <.05）。同样，双侧运动迟缓患者中有85.0%的SN增大且回声增强，相比之下单侧运动迟缓患者中这一比例为65.7%（P <.05）。SN回声性与面积之间存在显著相关性（r = 0.705；P <.01）。结论。SN增大且回声增强似乎是PD患者SN结构受累的一个标志。这种结构受累在双侧强直和运动迟缓患者中表现得更为明显。
