经颅彩色多普勒超声对帕金森病早期诊断的价值

Value of transcranial Doppler sonography in early diagnosis of Parkinson's disease

目的应用经颅彩色多普勒超声(TCS)与医学图像分析软件,通过测定灰度值定量分析帕金森病患者黑质病变。方法 63例帕金森病患者按病程分为两组,A组30例,病程<5年;B组33例,病程>10年;同期选择无帕金森病家族史,且排除帕金森综合征及其他锥体外系疾病的体检健康者35例为对照组。应用医学图像分析软件,用"手动分析"测得该区域平均灰度值,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,评定两侧黑质回声信号,同时与年龄、性别、病程做相关分析。结果对照组、A组、B组的黑质灰度值依次增高,病程越长灰度值越高,差异均有统计学意义(P<0.05)。帕金森病患者黑质灰度值与年龄、性别无相关性(r分别为0.019、0.032,P>0.05),灰度值与病程呈正相关(r=0.903,P=0.000)。结论黑质回声增强在帕金森病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帕金森病具有重要意义。

Objective To analyze the changes of substantia nigra in patients with Parkinson＇s disease using transcranial Doppler sonography（ TCS ） and medical image analysis software through the determination of gray value for quantitative analysis. Methods Sixty-three patients with Parkinson＇s disease were divided into two groups： 30 patients for A group （disease duration 〈 5 years） and 33 patients for B group （disease duration 〉 10 years）. In the same period, 35 heahhy subjects were selected as the control group which had no family history of Parkinson＇ s disease and were excluded parkinsonism and other extrapyramidal diseases. Average gray value of the region was measured using medical image analysis software ＂manual analysis＂. Quantitative indicators of echo intensity were identified by average gray values of the same parts on left and right hemispheres. Substantia nigra echoes signal of two sides were evaluated and was correlated with age, gender and disease duration. Results Substantia nigra gray values increased in turn in A group, B group and control group and the longer the disease duration was, the higher the gray value was （P 〈 0.05）. Substantia nigra gray values in patients with Parkinson＇s disease had no relationship with age and gender （r= 0.019,0.032,P 〉 0.05）, while correlated with disease duration（r=0.903, P=0.000）.Conclusion Substantia nigra echo enhancement in Parkinson＇s disease diagnosis is a stable marker and quantitative analysis of ultrasound gray value for the early diagnosis of Parkinson＇ s disease is important.