Paracelsus-Elena-Klinik, Center of Parkinsonism and Movement Disorders, Kassel, Germany.
Mov Disord. 2010 Apr 30;25(6):773-7. doi: 10.1002/mds.22981.
A normoechogenic substantia nigra (SN) is a typical finding in transcranial sonography in patients with progressive supranuclear palsy (PSP), whereas in patients with Parkinson's disease a hyperechogenic SN is characteristic. A recent classification scheme recommends the differentiation of PSP patients into those with Richardson's syndrome (RS) and those with PSP-Parkinsonism (PSP-P). We investigated 34 PSP patients (27 RS, 7 PSP-P) with ultrasound of the substantia nigra in search of differentiations in the two groups. We found that most of the PSP-P patients, according to recently published criteria, had a hyperechogenic SN (6 of 7): right (cm(2)) median 0.22, 25% percentile 0.21 and 75% percentile 0.36 (cm(2)); left (cm(2)) median 0.21, 25% percentile 0.20 and 75% percentile 0.30 and a normal third ventricle (mean mm) +/-SD: 7.1 +/- 2.43). In RS patients a normoechogenic SN (26 of 27) and an enlarged third ventricle (mean mm) +/-SD: 10.3 +/- 2.41) was found. These differences may elucidate the pathological differences of RS and PSP-P.
黑质回声正常是进行性核上性麻痹(transcranial sonography)患者的典型表现，而帕金森病患者的黑质表现为高回声。最近的分类方案建议将进行性核上性麻痹患者分为Richardson 综合征(Richardson's syndrome)和帕金森病型进行性核上性麻痹(parkinsonism PSP-P)。我们对 34 例进行性核上性麻痹患者（27 例 Richardson 综合征，7 例帕金森病型进行性核上性麻痹）进行了黑质超声检查，以寻找两组之间的差异。我们发现，根据最近公布的标准，大多数帕金森病型进行性核上性麻痹患者的黑质回声较高（7 例中的 6 例）：右侧（cm²）中位数为 0.22，25%位数为 0.21，75%位数为 0.36（cm²）；左侧（cm²）中位数为 0.21，25%位数为 0.20，75%位数为 0.30，第三脑室正常（mean mm）+/-SD：7.1 +/- 2.43）。Richardson 综合征患者的黑质回声正常（27 例中的 26 例），第三脑室扩大（mean mm）+/-SD：10.3 +/- 2.41）。这些差异可能阐明了 Richardson 综合征和帕金森病型进行性核上性麻痹的病理差异。
