Ambrosius W, Michalak S, Owecki M, Łukasik M, Florczak-Wyspiańska J, Kozubski W
Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland.
Folia Morphol (Warsz). 2014 Aug;73(3):267-71. doi: 10.5603/FM.2014.0042.
Hyperechogenicity of the substantia nigra (SN) measured by transcranial sonography (TCS) is a characteristic feature observed in patients with Parkinson's disease (PD). To our knowledge, no SN hyperechogenicity data are available for Polish population. Moreover most of studies come from few centres, which used the one type of ultrasound device. The main aim of the study was to investigate the association between PD and SN hyperechogenicity measured by sonographic machine, not assessed so far.
In this study cross-sectional study SN hyperechogenicity was evaluated in 102 PD patients and 95 control subjects. Midbrain was visualised by Aloka Prosound 7 ultrasound device. SN area measurement, the relation to the clinical features of PD, inter- and intra-observer reliability were evaluated.
We confirmed that SN echogenicity is significantly increased in PD patients compared to control subjects (p < 0.001). The area under curve for PD patients vs. controls was 0.93. Receiver operating characteristic analysis indicated a cut-offs for SN echogenicity at 0.19 cm² with accuracy equal to 90%, specificity - 86% and sensitivity - 93.7%. The SN hyperechogenicity was not related to PD clinical findings. Reliability was good if an experienced sonographer performed the SN measurements.
This study shows that the SN abnormality observed by TCS isa specific feature, which can be helpful in the process of PD diagnosing.
经颅超声检查(TCS)测量的黑质(SN)高回声是帕金森病(PD)患者的一个特征性表现。据我们所知,波兰人群尚无SN高回声的数据。此外,大多数研究来自少数几个中心,且使用的是同一种超声设备。本研究的主要目的是调查超声检查测量的PD与SN高回声之间的关联,这一点此前尚未评估。
在本横断面研究中,对102例PD患者和95例对照者进行了SN高回声评估。使用阿洛卡Prosound 7超声设备对中脑进行成像。评估了SN面积测量、与PD临床特征的关系以及观察者间和观察者内的可靠性。
我们证实,与对照者相比,PD患者的SN回声显著增强(p < 0.001)。PD患者与对照者的曲线下面积为0.93。受试者工作特征分析表明,SN回声的截断值为0.19 cm²,准确率为90%,特异性为86%,敏感性为93.7%。SN高回声与PD的临床发现无关。如果由经验丰富的超声检查人员进行SN测量,可靠性良好。
本研究表明,TCS观察到的SN异常是一个特异性特征,有助于PD的诊断过程。