Clinical application of transcranial sonography in the differential diagnosis of Parkinson's disease and Parkinson's superimposed syndrome
Objective To explore the value of transcranial sonography(TCS)in the differential diagnosis of Parkinson's disease(PD)and Parkinson's superimposed syndrome.Methods 40 patients with PD were selected as PD(20 case with early PD,20 cases with late PD)group,40 patients with Parkinson's superimposed syndrome[25 patients with multiple system atrophy P type(MSA-P),15 patients with progressive suprachinuclear paralysis(PSP)]as Parkinson's superimposed syndrome group,and 40 healthy individuals as the control group.PD group was divided into two subgroups:early PD group and late PD group,and Parkinson's superimposed syndrome group was divided into two subgroups:MSA-P group and PSP group.All subjects received TCS[midbrain substantia nigra(SN)hyperechogenicity,third ventricular width,lenticular nucleus(LN)hyperechogenicity,and midbrain area were examined,and the differences between every two groups were compared;compared the TCS results between MSA-P group and PSP group,and between early PD group and late PD group.Results The proportion of abnormal hyperechogenicity of LN in Parkinson's superimposed syndrome group was 75.0%(30/40),which was higher than 25.0%(10/40)in PD group and 2.5%(1/40)in control group,and the difference between groups was statistically significant(P<0.05).The proportion of abnormal hyperechogenicity of SN in PD group was 82.5%(33/40),which was higher than 62.5%(25/40)in Parkinson's superimposed syndrome group and 7.5%(3/40)in control group,and the difference between groups was statistically significant(P<0.05).The third ventricular width and midbrain area of Parkinson's superimposed syndrome group were(7.38±3.12)mm and(4.12±0.51)cm2,those of PD group were(5.54±1.86)mm and(4.42±1.42)cm2,and those of control group were(5.91±1.93)mm and(4.81±1.01)cm2.The third ventricular width in Parkinson's superimposed syndrome group was wider than that in PD group and control group,and the midbrain area was smaller than that in PD group and control group.The difference was statistically significant(P<0.05).The proportion of abnormal LN hyperechogenicity were 76.0%(19/25)and 73.3%(11/15)in MSA-P group and PSP group,and the differences between the groups were statistically significant(P<0.05).The proportion of abnormal SN hyperechogenicity was 76.0%(19/25)in MSA-P group,which was higher than 40.00%(6/15)in PSP group,and the difference was statistically significant(P<0.05).The third ventricular width and the midbrain area of the MSA-P group were(6.49±3.09)mm and(4.51±0.49)cm2,and those of the PSP group were(8.29±1.18)mm and(3.21±0.38)cm2.The third ventricular width in MSA-P group was narrower than that in PSP group,and the midbrain area was larger than that in PSP group,and the differences between the groups were statistically significant(P<0.05).There were no significant differences in the proportion of abnormal hyperechogenicity in LN,the third ventricular width and the middle brain area between the early PD group and the late PD group(P>0.05).Abnormal SN hyperechogenicity occurred in 19 cases(95.0%)in the early PD group and 14 cases(70.0%)in the late PD group,and the difference was statistically significant(P<0.05).Conclusion The occurrence rate of SN strong echogenicity is high in early PD,however,the proportion of abnormal SN hyperechogenicity of MSA-P is higher than that of PSP and accompanied by large midbrain area.In PSP,the third ventricle widened,the midbrain area decreased significantly,while the strong echogenicity ratio in SN is small.
万方数据
维普
