Smajlovic Dzevdet, Ibrahimagic Omer C
Department of Neurology, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
Medical Faculty, University of Tuzla, Bosnia and Herzegovina, Tuzla, Bosnia and Herzegovina.
Med Arch. 2017 Aug;71(4):261-264. doi: 10.5455/medarh.2017.71.261-264.
Transcranial sonography (TCS) is a relatively new ultrasound modality which could display echogenicity of human brain tissue through the intact skull. TCS may be useful in differentiation of idiopathic Parkinson's disease (PD) from other parkinsonian disorders. Therefore, we studied different ultrasound markers by TCS in individuals with Parkinson's disease.
We performed TCS in 44 patients with PD and 22 patients with other parkinsonian disorders. Echogenic sizes of the substantia nigra (SN) and the lentiform nuclei (LN), as well as the width of the third ventricle and the frontal horns of the lateral ventricle, were measured. We also analyzed the echogenicity of the brainstem raphe (BR).
An unilateral hyperechogenic SN was observed in 31 (70%) patients with PD and only in 2 patients (9%) with other parkinsonian disorders (P<0.0001). Hyperechogenicity of the LN was no observed in patients with PD; however, it was present in 7 (32%) patients with other parkinsonian disorders (P=0.0002). Diameter of third ventricle (8.6+/-2.2 mm vs. 6.9+/-1.7mm, P=0.001), right (18.5+/-2.6 mm vs. 16.5+/-2.3 mm, P=0.003) and left frontal horn of lateral ventricle (19.0+/-3.7 mm vs. 16.2+/-2.6 mm, P=0.0006) was significantly wider in patients with other parkinsonian disorders compared with patients with PD. There was no difference in presence of hypoechogenic or interrupted BR in patients with PD and patients with other parkinsonian disorders (39% vs. 27%, P=0.4).
TCS is a promising diagnostic technique and can be very helpful in differentiating between idiopathic Parkinson's disease and other parkinsonian disorders.
经颅超声检查（TCS）是一种相对较新的超声检查方式，它能够透过完整的颅骨显示人脑组织的回声。TCS在鉴别特发性帕金森病（PD）与其他帕金森综合征方面可能具有一定作用。因此，我们通过TCS研究了帕金森病患者的不同超声标志物。
我们对44例帕金森病患者和22例其他帕金森综合征患者进行了TCS检查。测量了黑质（SN）和豆状核（LN）的回声大小，以及第三脑室和侧脑室额角的宽度。我们还分析了脑干中缝核（BR）的回声情况。
31例（70%）帕金森病患者观察到单侧黑质高回声，而其他帕金森综合征患者仅2例（9%）出现（P<0.0001）。帕金森病患者未观察到豆状核高回声；然而，7例（32%）其他帕金森综合征患者出现了豆状核高回声（P=0.0002）。与帕金森病患者相比，其他帕金森综合征患者的第三脑室直径（8.6±2.2mm对6.9±1.7mm，P=0.001）、右侧（18.5±2.6mm对16.5±2.3mm，P=0.003）和左侧侧脑室额角（19.0±3.7mm对16.2±2.6mm，P=0.0006）明显更宽。帕金森病患者与其他帕金森综合征患者之间低回声或中断的脑干中缝核出现情况无差异（39%对27%，P=0.4）。
TCS是一种很有前景的诊断技术，在鉴别特发性帕金森病和其他帕金森综合征方面非常有帮助。
