Transcranial sonography of the substantia nigra and its correlation with DAT-SPECT in the diagnosis of Parkinson's disease
Transcranial sonography of the substantia nigra and its correlation with DAT-SPECT in the diagnosis of Parkinson's disease
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经颅黑质超声检查及其与DAT-SPECT诊断帕金森病的相关性
DOI：
10.1016/j.parkreldis.2015.05.024
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发表时间：
2015-08-01
影响因子：
4.1
通讯作者：
Chen, Sheng-di
中科院分区：
文献类型：
--
作者：
Li, Dun-hui;Zhang, Lin-yuan;Chen, Sheng-di
简介：经颅黑质超声检查（TCS）是一种新的和有前途的方法来诊断帕金森病（PD），但其有效性是有争议的。方法：所有55例PD患者参与了这项研究进行单光子发射计算机断层扫描（SPECT）成像使用标记的多巴胺转运蛋白放射性示踪剂Tc-99 m-TRODAT-1评估黑质纹状体多巴胺能功能。所有患者均行DAT-SPECT扫描，用TCS测量黑质回声强度。最后，统计分析TCS的诊断准确性及其与Tc-99 m-TRODAT-1 SPECT的相关性，阳性预测值（PPV）和阴性预测值（NPV）。与同侧纹状体摄取相比，同侧纹状体摄取显著降低，并且与TcRS-III呈负相关（r =-0.334，p = 0.013）、病程（r =-0.393，p = 0.003）和H-Y分期（r =-0.330，p = 0.014）。TCS测量后，对侧SN回声区与同侧SN回声区相似（27.77 +/- 13.19 vs 25.98 +/- 11.94 mm（2），p = 0.402，n = 24）。TCS与TCRS-III（r = 0.383，p = 0.065）、病程（r = 0.371，p = 0.075）或H Y分期（r = 0.259，p = 0.222）之间未发现相关性。DAT-SPECT诊断PD的敏感性和特异性分别为64.70%和60%，阳性预测值和阴性预测值分别为91.67%和20%。在我们的研究中，TCS与DAT-SPECT无相关性。然而，TCS的高阳性预测值突出了其作为常规诊断测试的可能效用。(C)2015爱思唯尔有限公司版权所有。
Introductions: Transcranial sonography (TCS) of the substantia nigra is a new and promising method to diagnose Parkinson's disease (PD) but its effectiveness is controversial.Methods: All 55 PD patients involved in the study underwent single photon emission computed tomography (SPECT) imaging using the labeled dopamine transporter radiotracer Tc-99m-TRODAT-1 to assess nigrostriatal dopaminergic function. The echogenicity of the substantia nigra was measured by TCS in all patients who received DAT-SPECT scanning. Finally, statistical analysis was carried out to determine the diagnostic accuracy of TCS as well as its correlation with Tc-99m-TRODAT-1 SPECT, its positive predictive value (PPV), and negative predictive value (NPV).Results: Contralateral striatal Tc-99m-TRODAT-1 uptake was significantly reduced compared to ipsilateral striatal uptake, and had a negative correlation with UPDRS-III(r = -0.334, p = 0.013), disease duration (r = -0.393, p = 0.003) and H-Y stage (r = -0.330, p = 0.014). After TCS measurement, the contralateral SN echogenic area was similar to the ipsilateral SN echogenic area (27.77 +/- 13.19 vs 25.98 +/- 11.94 mm(2), p = 0.402, n = 24). No correlation was identified between TCS and UPDRS-III (r = 0.383, p = 0.065), disease duration (r = 0.371, p = 0.075) or H Y stage (r = 0.259, p = 0.222). The sensitivity and specificity of SN TCS for the diagnosis of PD were calculated as 64.70% and 60% according to DAT-SPECT, respectively, while the positive predictive value and negative predictive value was calculated as 91.67% and 20%, respectively.Conclusions: Compared to DAT-SPECT, TCS is a non-radioactive and convenient procedure to perform. In our investigation, TCS had no correlation with DAT-SPECT. However, the high positive predictive value of TCS highlights its possible utility as a routine diagnostic test. (C) 2015 Elsevier Ltd. All rights reserved.