黑质高回声数字化分析在帕金森病患者中的诊断价值

Quantity detection of substantia nigra hyperechogenicity based on digital analysis for diagnosing Parkinson's disease

目的通过数字化分析方法自动分割并定量经颅超声检查下黑质回声的变化,并评估其在帕金森病患者中的应用前景。方法纳入自2017年11月至2020年10月在华中科技大学同济医学院附属同济医院就诊的652例帕金森病患者(帕金森病组)和99名健康对照者(健康对照组),对其进行经颅超声检查。应用数字化分析方法分析经颅超声图像黑质层面的图片,对得到的黑质高回声的定量化数值采用受试者工作特征(ROC)曲线分析其对帕金森病的诊断性能,并与医生报告的诊断准确性进行比较。最后将定量化的黑质高回声与帕金森病的疾病特点进行相关分析。结果共得到482例研究对象的黑质高回声定量化结果用于分析,其中帕金森病组400例,健康对照组82名。ROC曲线分析结果显示,定量化的较大侧黑质高回声诊断帕金森病的曲线下面积为0.858(95%CI 0.805~0.910),敏感度87.8%,特异度73.2%,该诊断的准确性与医生报告(曲线下面积0.884)一致。此外,定量化的黑质高回声与帕金森病患者的年龄、发病年龄、病程、运动症状、非运动症状均无相关性(均P>0.05)。结论采用数字化分析方法量化了黑质回声的变化,验证了该方法对帕金森病的诊断准确性与医生报告一致。

Objective To apply digital analysis to quantify hyperechogenicity of substantia nigra,and explore its clinical value for diagnosis of Parkinson's disease(PD).Methods The cross-sectional study included 652 PD patients(PD group)and 99 healthy controls(healthy control group)from November 2017 to October 2020 in Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology.All subjects underwent transcranial sonography.The diagnostic accuracy of substantia nigra hyperechogenicity using digital analysis was compared with that in a manual measurement in PD.Furthermore,the receiver operating characteristic(ROC)curve analysis was applied to explore its diagnosis value in PD.Results There were 482 subjects including 400 in the PD group and 82 in the healthy control group,whose quantified results of substantia nigra hyperechogenicity could be used for analysis.The ROC analysis showed that the area under the curve of the quantified larger substantia nigra hyperechoic region detection for diagnosing PD was 0.858(95%CI 0.805-0.910),the sensitivity was 87.8%,and the specificity was 73.2%,consistent with that of doctors(area under the curve:0.884).Further more,among these PD patients,there was no correlation between larger substantia nigra hyperechogenicity and age,age of onset,course of disease,non-motor symptoms,and motor symptoms(all P>0.05).Conclusions Digital analysis was used to quantify the changes in substantia nigra hyperechogenicity in this seudy.The results showed that diagnostic accuracy for PD based on digital analysis was consistent with that of experienced clinicians.