Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ultrasound Med Biol. 2020 May;46(5):1208-1215. doi: 10.1016/j.ultrasmedbio.2020.01.019. Epub 2020 Feb 24.
To determine the diagnostic performance of transcranial sonography (TCS) in assessing increased echogenic area of the substantia nigra (SN) in patients with Parkinson's disease (PD). Institutional review board approval was obtained for this retrospective study. A total of 278 PD patients (mean age: 64.7 ± 9.8 y, 100 women) and 300 healthy control patients (mean age: 63.6 ± 9.3 y, 97 women) were referred for TCS assessment of SN hyper-echogenicity (SN+) from June 2016 to December 2018. Two sonographers independently measured the sizes of the echogenic areas of the SN by TCS imaging in both PD patients and healthy controls. The diagnostic sensitivity, specificity and accuracy of TCS imaging were compared between PD patients and healthy controls. Inter-rater agreement was assessed with the Cohen's κ statistic. The sensitivity, specificity and accuracy of readers 1 and 2, respectively, for the identification of SN+ in TCS were 90.3% and 89.6% (251 and 249 of 278), 89.3% and 88.3% (268 and 265 of 300) and 89.8% and 88.9% (519 and 514 of 578). Inter-observer agreement was excellent (к = 0.84). The area under the receiver operating characteristic curve (AUC) for differentiation of PD patients from healthy controls was 0.92 for reader 1 and 0.91 for reader 2. Cutoff values of 0.20 and 0.21 cm were derived from the assessments performed by readers 1 and 2, respectively. We defined 0.20 cm as the optimal cutoff value because it had a higher AUC. TCS is a promising diagnostic technique and can be very helpful in differentiating PD patients from healthy individuals.
为了确定经颅超声（TCS）在评估帕金森病（PD）患者黑质（SN）回声增强面积方面的诊断性能。本回顾性研究获得了机构审查委员会的批准。 2016 年 6 月至 2018 年 12 月，共有 278 名 PD 患者（平均年龄：64.7 ± 9.8 岁，100 名女性）和 300 名健康对照患者（平均年龄：63.6 ± 9.3 岁，97 名女性）因 TCS 评估 SN 高回声（SN+）而被转诊。两名超声医师分别通过 TCS 成像对 PD 患者和健康对照组的 SN 回声区域的大小进行独立测量。比较 PD 患者和健康对照组之间 TCS 成像的诊断灵敏度、特异性和准确性。采用 Cohen's κ 统计量评估观察者间一致性。读者 1 和 2 分别识别 TCS 中 SN+的敏感性、特异性和准确性为 90.3%和 89.6%（278 例中有 251 例和 249 例）、89.3%和 88.3%（300 例中有 268 例和 265 例）和 89.8%和 88.9%（578 例中有 519 例和 514 例）。观察者间一致性极好（к=0.84）。用于区分 PD 患者和健康对照者的受试者工作特征曲线（ROC）下面积（AUC）为读者 1 的 0.92 和读者 2 的 0.91。读者 1 和读者 2 的评估分别得出 0.20 和 0.21 cm 的截断值。我们将 0.20 cm 定义为最佳截断值，因为它具有更高的 AUC。TCS 是一种很有前途的诊断技术，对于区分 PD 患者和健康个体非常有帮助。
