经颅彩色编码超声诊断帕金森综合征的临床价值

目的 探讨经颅彩色编码超声(TCCS)诊断帕金森综合征(PD)的价值。方法 选择52例PD患者(PD组)和50例健康人群(对照组)，经颞窗探查中脑区黑质(SN)的回声强度，对其进行分级，并测量SN强回声的面积及双侧黑质强回声/中脑面积(S/M)值。结果 TCCS显示SN出现强回声41 (/52, 78.8%)例，而对照组出现SN强回声为19 (24.0%)例，两组差异有统计学意义(X 2 = 4.766, P = 0.000)。PD组单侧SN强回声面积0.34±0.10 cm2，S/M为11±4%；对照组单侧SN强回声面积0.17±0.05 cm2，S/M为5±1%。PD组与对照组SN强回声面积及S/M均有明显统计学差异(t = 9.859, p = 0.000; t = 10.394, p = 0.000)。依据受试者工作特征曲线，以S/M为6.5%作为诊断PD临界值，其曲线下面积为0.964，敏感性为98.1%，特异性为84.6%；以单侧SN强回声面积0.215作为诊断PD的临界值，其曲线下面积为0.929，敏感性为88.5%，特异性为75.0%。结论 TCCS对于预测正常人群中罹患PD的风险及早期诊断PD具有重要临床应用价值。

The clinical value of transcranial color coded ultrasonography in diagnosing Parkinson's syndrome

Objectives To investigate the value of transcranial color-code sonography (TCCS) in the diagnosis of Parkinson disease (PD). Methods Selected 52 cases of PD patients and 50 cases of healthy individuals, calculated the area of substantia nigra (SN) and hyperechogenic substantia nigra/midbrain (S/M). Results Hyperechogenic SN appeared in PD and control group in 41 (/52, 78.8%) and 19 (24.0%), respectively, they were statistical difference (X 2 = 4.766, P = 0.000). The area of hyperechogenic SN in PD group was 0.34±0.10 cm2 and the S/M was and 11±4% in PD group. However, the area of hyperechogenic SN in control group was 0.17±0.05 cm2 and the S/M was and 5±1% in control group. There was significantly statistical difference between two groups (t = 9.859, p = 0.000; t = 10.394, p = 0.000). According to receiver operating characteristic curve, using S/M = 6.5% and hyperechogenic SN = 0.215, the area under curve, sensitivity and specificity of TCCS in diagnosis of PD was 0.964, 98.1% and 84.6% and 0.929, 88.5% and 75.0%, respectively. Conclusion TCCS plays a very important role both in predicting the risk of PD in healthy individuals and in early diagnosing the PD.