经颅彩色多普勒超声对帕金森病早期诊断的研究
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摘要
目的:经颅彩色多普勒超声(TCS)与医学图像分析软件,通过对灰度值的测定,对帕金森病(PD)患者黑质病变进行定量分析。方法:按照病程对患者进行分组,5年内PD患者,10年以上PD患者;同期选择无PD家族史对照组,应用医学图像分析软件,用"手动分析"测得该区域的平均灰度值,并以大脑左右半球相同部位的平均灰度值作为回声强度的量化指标,进行两侧黑质(SN)回声信号的评定。结果:1灰度值在PD病人中,与年龄、性别、病程做相关分析,灰度值与年龄无显著相关性(r=0.019,P=0.849);灰度值与性别无显著相关性(r=0.032,P=0.753);灰度值与病程呈显著正相关(r=0.903,P=0.000);2对照组与5Y-PD组、10Y-PD组灰度值比较中,病程越长、灰度值越高。结论:黑质回声增强在PD的诊断中是稳定的标记,超声灰度值定量分析对于早期诊断PD具有重要意义。
Purpose: To study the substantia nigra in patients with Parkinson's disease( PD) by transcranial Doppler sonography( TCS). Methods: According to the course of disease, the patients were divided into 2 group: patients with PD less than 5 years, patients with PD more than 10 years. Volunteers with no family history of PD were chosen as control group. Echo signals of both sides of the substantia nigra(SN) were evaluated by using the average gray value of the same parts of the brain hemisphere as the quantitative echo intensity indicator. Results: Gray values were not correlated with age(r=0.019, P=0.849); no significant correlation existed between gray values and gender(r=0.032, P=0.753); significant positive correlation existed between gray values and disease course(r=0.903, P=0.000). Conclusion:Substantia nigra with echo enhancement is a stable mark in the diagnosis of PD, quantitative analysis of ultrasonographic gray value is of great significance for early diagnosis of PD.
Purpose: To study the substantia nigra in patients with Parkinson's disease( PD) by transcranial Doppler sonography( TCS). Methods: According to the course of disease, the patients were divided into 2 group: patients with PD less than 5 years, patients with PD more than 10 years. Volunteers with no family history of PD were chosen as control group. Echo signals of both sides of the substantia nigra(SN) were evaluated by using the average gray value of the same parts of the brain hemisphere as the quantitative echo intensity indicator. Results: Gray values were not correlated with age(r=0.019, P=0.849); no significant correlation existed between gray values and gender(r=0.032, P=0.753); significant positive correlation existed between gray values and disease course(r=0.903, P=0.000). Conclusion:Substantia nigra with echo enhancement is a stable mark in the diagnosis of PD, quantitative analysis of ultrasonographic gray value is of great significance for early diagnosis of PD.
引文
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[2]中华医学会神经病学分会运动障碍及帕金森病学组.帕金森病的诊断.中华神经科杂志,2006,39:408-409.
[3]Berg D,Roggendorf W,Schroder U,et al.Echogenicity of thesubstantia nigra:association with increased iron content and marker for susceptibility to nigrostriatal injury.Arch Neurol,2002,59:999–1005.
[4]Becker G,Berg D.Neuroimaging in basal ganglia disorders:perspectives for transcranial ultrasound.Mov Disord,2001,16:23-32.
[5]Boelmans K,Bodammer NC,Suchorska B,et al.Diffusion tensor imaging of the corpus callosum differentiates corticobasal syndrome from Parkinson’s disease.Parkinsonism Relat Disord,2010,16:498-502.
[6]Riederer P,Dirr A,Goetz M,et al.Distribution of iron in different brain regions and subcellular compartments in Parkinson’s disease.J Ann Neurol,2012,32(Suppl):S101-S104.
[7]Nielsen PK,Jensen BR,Darvann T,et al.Quantitativeultrasound tissue characterization in shoulder and thighmuscles:a new approach.BMC Musculoskelet Disord,2006,18:2.
[8]汪小毅,林江莉,李德玉,等.基于纹理分析的脂肪肝B超图像识别.航天医学与医学工程,2004,17:144-148.
[9]吴江苇,潘翠珍,王宜杰.扩张型心肌病心肌组织灰阶定量的临床应用价值.同济大学学报:医学版,2002,23:320-322.
[10]Behnke S,Berg D,Naumann M,et al.Differentiation of Park in son,s disease and atypical parkinsonian synromes by transcran ialultrasound.Jneurol Neurosurg Psychiatry,2005,76:423-425.
[11]Gaenslen A,Unmuth B,Godau J,et al.The specificity and sensitivityof transcranial ultrasound in the differential diagnosis of Parkinson’s disease:a prospective blinded study.Lancet Neurol,2008,7:417-424.