[1]张存程,凌镜,黄莺,等.经颅超声结合磁敏感加权成像技术在帕金森综合征诊断中的应用[J].第三军医大学学报,2020,42(01):25-30.
 ZHANG Cuncheng,LING Jing,HUANG Ying,et al.Combination of transcranial ultrasound and susceptibility weighted imaging in diagnosis of Parkinsonism[J].J Third Mil Med Univ,2020,42(01):25-30.
点击复制

经颅超声结合磁敏感加权成像技术在帕金森综合征诊断中的应用(/HTML )
分享到:

《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
42卷
期数:
2020年第01期
页码:
25-30
栏目:
神经科学
出版日期:
2020-01-15

文章信息/Info

Title:
Combination of transcranial ultrasound and susceptibility weighted imaging in diagnosis of Parkinsonism
作者:
张存程凌镜黄莺杜雅灵王志刚李奇林
重庆医科大学附属第二医院超声科,超声分子影像重庆市重点实验室;中国科学院大学重庆医院,重庆市人民医院超声科
Author(s):
ZHANG Cuncheng LING Jing HUANG Ying DU Yaling WANG Zhigang LI Qilin

Chongqing Key Laboratory of Ultrasound Molecular Imaging, Department of Ultrasonography, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400016; 2Department of Ultrasonography, Chongqing General Hospital, Chinese Academy of Sciences, Chongqing, 400014, China

关键词:
经颅超声磁敏感加权成像帕金森综合征帕金森病
Keywords:
transcranial ultrasound susceptibility weighted imaging Parkinsonism Parkinson&rsquos disease
分类号:
R445.1; R742.5
文献标志码:
A
摘要:

目的 研究帕金森综合征(Parkinsonism)人群利用经颅超声(transcranial ultrasound,TCS)发现中脑黑质回声增强(SN+)及磁敏感加权成像(susceptibility weighted imaging, SWI)发现“燕尾征”消失(loss of swallow tail sign,LSTS+)对帕金森病(Parkinson’s disease, PD)诊断的临床应用价值。方法 以2016年7月至2018年12月在重庆市人民医院住院治疗的116例帕金森综合征患者为研究对象,其中62例为PD组,54例为非PD组。分析帕金森综合征人群中脑黑质TCS及SWI的图像特征,通过比较分别使用TCS发现SN+和SWI发现LSTS+,以及联合使用以上两种方法诊断PD的敏感性与特异性和ROC曲线,研究TCS结合SWI在帕金森综合征诊断中的价值。结果PD患者SWI发现LSTS+及TCS发现SN+较非PD患者比例明显增高,以SN+与LSTS+为指标诊断帕金森病的敏感性、特异性、曲线下面积分别为80.6%、66.7%、0.737和88.7%、64.8%、0.768,联合应用两种指标诊断PD的敏感性、特异性、曲线下面面积分别为71.0%、88.9%、0.809。结论 帕金森综合征患者人群中,使用TCS和SWI的结果为指标诊断PD的效能相似,但使用TCS的经济性与便捷性更佳,联合两种指标较单一指标诊断PD的敏感性下降,特异性有所提高。

Abstract:

ObjectiveTo analyze the diagnostic value of combination of transcranial ultrasound (TCS) found substantia nigra hyperechogenicity (SN+) and susceptibility weighted imaging (SWI) found loss of “swallow tail sign” (LSTS+) to diagnose parkinsonism, and assess the clinical value of TCS and SWI in the diagnosis of Parkinson’s disease (PD). MethodsA total of 116 patients with parkinsonism admitted the Chongqing People’s Hospital from July 2016 to December 2018 were recruited in this study. And 62 of them were in the PD group and 54 in the non-PD group. The image features of TCS for nigra and SWI were analyzed in these parkinsonism patients. With SN+ found by TCS and LSTS+ found by SWI as indicators, receiver operating characteristic (ROC) curve was used to analyze the sensitivity, specificity, and area under the curve (AUC) of the 2 examinations alone or combined together in diagnosis of PD. ResultsThere were more patients with SN+ by TCS or LSTS+ by SWI in the PD patients than the non-PD patients. The sensitivity, specificity and AUC of diagnosis of by using SN+ and LSTS+ to diagnose PD were 80.6%, 66.7%, 0.737 and 88.7%, 64.8%, 0.768, respectively. However, the sensitivity and specificity and AUC of their combination for the diagnosis were 71.0%, 88.9%, and 0.809. ConclusionIn patients with parkinsonism, the results of TCS and SWI have similar efficacy in the diagnosis of PD, but TCS is better in economics and convenience. Although the sensitivity is decreased when the 2 examinations combine together, the specificity is greatly improved.

参考文献/References:

[1]BECKER G, SEUFERT J, BOGDAHN U, et al. Degeneration of substantia nigra in chronic Parkinson’s disease visualized by transcranial color-coded real-time sonography[J]. Neurology, 1995, 45(1): 182-184. DOI:10.1212/wnl.45.1.182.
[2]TAO A, CHEN G Z, DENG Y B, et al. Accuracy of transcranial sonography of the substantia nigra for detection of Parkinson’s disease: A systematic review and meta-analysis[J]. Ultrasound Med Biol, 2019, 45(3): 628-641. DOI:10.1016/j.ultrasmedbio.2018.11.010.
[3]STEZIN A, NADUTHOTA R M, BOTTA R, et al. Clinical utility of visualisation of nigrosome-1 in patients with Parkinson’s disease[J]. Eur Radiol, 2018, 28(2): 718-726. DOI:10.1007/s00330-017-4950-5.
[4]FAIZ K W, PIHLSTRM L. Parkinson’s disease and parkinsonism[J]. Tidsskr Nor Laegeforen, 2017, 137(4): 298. DOI:10.4045/tidsskr.16.0915.
[5]杨仕林, 吴云成. 帕金森病痴呆相关临床研究进展[J]. 中国现代神经疾病杂志, 2017, 17(2): 95-100. DOI:10.3969/j.issn.1672-6731.2017.02.003.
YANG S L, WU Y C. Progress of clinical research of Parkinson’s disease dementia[J]. Chin J Contemp Neurol Neurosurg, 2017, 17(2): 95-100. DOI:10.3969/j.issn.1672-6731.2017.02.003.
[6]WANG Z B, LUO X G, GAO C. Utility of susceptibility-weighted imaging in Parkinson’s disease and atypical Parkinsonian disorders[J]. Transl Neurodegener, 2016, 5: 17. DOI:10.1186/s40035-016-0064-2.
[7]SHAFIEESABET A, FERESHTEHNEJAD S M, SHAFIEESABET A, et al. Hyperechogenicity of substantia nigra for differential diagnosis of Parkinson’s disease: A meta-analysis[J]. Parkinsonism Relat Disord, 2017, 42: 1-11. DOI:10.1016/j.parkreldis.2017.06.006.
[8]中华医学会神经病学分会帕金森病及运动障碍学组,中国医师协会神经内科医师分会帕金森病及运动障碍专业委员会.中国帕金森病的诊断标准(2016版)[J].中华神经科杂志,2016,49(4):268-271.DOI: 10.3760/cma.j.issn.1006-7876.2016.04.002
Parkinson’s Disease and Motor Disorder Group in Neurology Branch of Chinese Medical Association, Parkinson’s Disease and Motor Disorder in Branch of Neurology of Chinese Medical Association. Diagnostic criteria for Parkinson’s disease in China (2016)[J]. Chin J Neurol, 2016, 49(4):268-271. DOI: 10.3760/cma.j.issn.1006-7876.2016.04.002
[9]BERG D, GODAU J, WALTER U. Transcranial sonography in movement disorders[J]. Lancet Neurol, 2008, 7(11): 1044-1055. DOI:10.1016/S1474-4422(08)70239-4.
[10]WALTER U, BEHNKE S, EYDING J, et al. Transcranial brain parenchyma sonography in movement disorders: state of the art[J]. Ultrasound Med Biol, 2007, 33(1): 15-25. DOI:10.1016/j.ultrasmedbio.2006.07.021.
[11]朱见文, 赵璨, 张伟, 等. 经颅黑质超声诊断帕金森病的临床评价[J]. 临床荟萃, 2018, 33(5): 413-415. DOI:10.3969/j.issn.1004-583x.2018.05.012.
ZHU J W, ZHAO C, ZHANG W, et al. Transcranial sonography in diagnosis of Parkinson’s disease[J]. Clin Focus, 2018, 33(5): 413-415. DOI:10.3969/j.issn.1004-583x.2018.05.012.
[12]梁建庆. 帕金森病的发病机制、诊断标准及治疗策略[J]. 解放军医学杂志, 2018, 43(8): 631-635. DOI:10.11855/j.issn.0577-7402.2018.08.01.
LIANG J Q. Pathogenesis, diagnosis and treatment strategies of Parkinson’s disease[J]. Med J Chin PLA, 2018, 43(8): 631-635. DOI:10.11855/j.issn.0577-7402.2018.08.01.
[13]刘丹, 杨成林, 陈芳. 早期帕金森病误诊分析[J]. 临床误诊误治, 2017, 30(5): 32-35. DOI:10.3969/j.issn.1002-3429.2017.05.011.
LIU D, YANG C L, CHEN F. Misdiagnosis in early Parkinson’s disease[J]. Clin Misdiagn Misther, 2017, 30(5): 32-35. DOI:10.3969/j.issn.1002-3429.2017.05.011.
[14]CHEN W, TAN Y Y, HU Y Y, et al. Combination of olfactory test and substantia nigra transcranial sonopraphy in the differential diagnosis of Parkinson’s disease: a pilot study from China[J]. Transl Neurodegener, 2012, 1(1): 25. DOI:10.1186/2047-9158-1-25.
[15]LORIO S, SAMBATARO F, BERTOLINO A, et al. The combination of DAT-SPECT, structural and diffusion MRI predicts clinical progression in Parkinson’s disease[J]. Front Aging Neurosci, 2019, 11: 57. DOI:10.3389/fnagi.2019.00057.
[16]LIU Z, SHEN H C, LIAN T H, et al. Iron deposition in substantia nigra: abnormal iron metabolism, neuroinflammatory mechanism and clinical relevance[J]. Sci Rep, 2017, 7(1): 14973. DOI:10.1038/s41598-017-14721-1.
[17]王娜, 杨华光, 李成博, 等. “燕尾征”在原发性帕金森病及多系统萎缩中的鉴别诊断价值[J]. 中国医学影像学杂志, 2018, 26(1): 11-15. DOI:10.3969/j.issn.1005-5185.2018.01.003.
WANG N, YANG H G, LI C B, et al. Identification and diagnostic value of “Swallow tail appearance” in idiopathic Parkinson’s disease and multi system atrophy[J]. Chin J Med Imaging, 2018, 26(1): 11-15. DOI:10.3969/j.issn.1005-5185.2018.01.003.
[18]LOTANKAR S, PRABHAVALKAR K S, BHATT L K. Biomarkers for Parkinson’s disease: recent advancement[J]. Neurosci Bull, 2017, 33(5): 585-597. DOI:10.1007/s12264-017-0183-5.

相似文献/References:

[1]赵骏,陈伟,周代全,等.SWI序列诊断膝关节半月板撕裂的可行性研究[J].第三军医大学学报,2012,34(19):2002.
 Zhao Jun,Chen Wei,Zhou Daiquan,et al.Diagnosis of meniscal tear of knee joint by SWI sequence: a feasibility study[J].J Third Mil Med Univ,2012,34(01):2002.
[2]郭大静,陈维娟,吴伟,等.磁敏感加权成像对脑梗死的诊断价值[J].第三军医大学学报,2010,32(02):176.
 Guo Dajing,Chen Weijuan,Wu Wei,et al.Diagnostic value of susceptibility weighted imaging in cerebral infarction: report of 38 cases[J].J Third Mil Med Univ,2010,32(01):176.
[3]张永克,赵骏,王健,等.脂肪抑制质子加权成像和磁敏感加权成像诊断膝关节半月板撕裂对比研究[J].第三军医大学学报,2013,35(23):2586.
 Zhang Yongke,Zhao Jun,Wang Jian,et al.Fat-suppressed proton density-weighted imaging vs susceptibility weighted imaging in diagnosis of meniscal tear[J].J Third Mil Med Univ,2013,35(01):2586.

更新日期/Last Update: 2020-01-07