Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany.
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Ultraschall Med. 2017 Jun;38(3):294-300. doi: 10.1055/s-0042-107150. Epub 2016 Jun 7.
One of the anatomical hallmarks of Alzheimer's disease (AD) is the atrophy of the medial temporal lobe (MTL), yet cost-effective and broadly available methodological alternatives to the current imaging tools for screening of this brain area are not currently available. Using structural transcranial ultrasound (TCS), we attempted to visualize and measure the MTL, and compared the results of 32 AD patients and 84 healthy controls (HC). The MTL and the surrounding space were defined in the coronal plane on TCS. A ratio of the height of the MTL/height of the choroidal fissure (M/F) was calculated in order to obtain a regional proportion. An insufficient temporal bone window was identified in 22 % of the AD patients and 12 % of the HCs. The results showed that the ratio of M/F was significantly smaller in the AD group on both sides (p = 0.004 right, p = 0.007 left side). Furthermore, the M/F ratio made it possible to discriminate AD patients from HCs with a sensitivity of 83 % (right)/73 % (left) and a specificity of 76 % (right)/72 % (left) which is basically comparable to results published for magnetic resonance imaging. The measurements showed substantial intra/interrater reliability (ICC:0.79/0.69). These results suggest that utilization of structural TCS may possibly constitute a cheap and easy-to-use supplement to other techniques for the diagnosis of AD. It may be especially useful as a screening tool in the large population of individuals with cognitive decline. Further studies are needed to validate this novel method.
阿尔茨海默病（AD）的解剖学标志之一是内侧颞叶（MTL）的萎缩，但目前还没有经济实惠且广泛可用的方法来替代当前用于筛查该脑区的成像工具。我们使用结构经颅超声（TCS）试图可视化和测量 MTL，并比较了 32 名 AD 患者和 84 名健康对照者（HC）的结果。在 TCS 的冠状面上定义了 MTL 和周围的空间。为了获得区域比例，计算了 MTL/脉络膜裂高度（M/F）的比值。在 22%的 AD 患者和 12%的 HCs 中，颞骨窗不足。结果表明，在双侧 AD 组中，M/F 比值明显较小（右侧 p=0.004，左侧 p=0.007）。此外，M/F 比值能够以 83%（右侧）/73%（左侧）的灵敏度和 76%（右侧）/72%（左侧）的特异性将 AD 患者与 HCs 区分开来，这基本上与磁共振成像（MRI）的结果相当。测量结果显示出相当大的内部/内部观察者可靠性（ICC：0.79/0.69）。这些结果表明，结构 TCS 的应用可能是 AD 诊断中其他技术的一种廉价且易于使用的补充方法。它可能特别适用于认知能力下降的大量个体的筛查工具。需要进一步的研究来验证这种新方法。
