| Purpose 1.Transcranial Sonography(TCS)is used for assisting to diagnosis Parkinson's disease by detecting the hyperechogenicity of the substantia and measuring the area of hyperechogenicity.The research estimate the value of TCS in diagnosis of PD in this respect.2.Application of statistical software analysis Statistical differences in the hyperechogenicity of the substantia between Parkinson's patients and normal controls.3.The research analysis the correlation between the hyperechogenicity of the substantia and age,course of the disease,the severity of condition on PD.Method 1.Our research select the 67 Parkinson's disease patients who come from Department of Neurology of Affiliated Union Hospital of Fujian Medical University and are diagnosised by Queen Square Brain Bank UK PDS Brain Bank Criteria for the diagnosis of PD as the case group.Their ages are located in 36-84 years old,All PD patients underwent UPDRS-III,and Hoehn-Yahr Rating Scale(H-Y).The UPDRS results can be divided into mild(below 10 points),moderate(11-20),severe(21-30).This research select the 68 healthy person as the control group without Family history of Parkinson's disease,ruling out Parkinson'syndrome,Vascular Parkinsonism and the other extrapyramidal disease.The case group and the control group match in age?sex.2.This research use Philips IE33-BOMJH1 color Doppler ultrasonography through temporal window,along the orbitomeatal line to explorate the presence of the hyperechogenicity of the substantia.If the the hyperechogenicity of the substantia is detected,then we measure the hyperechogenic area.Abnormal echo is based on the area and intensity of The substantia nigra's echogenic signals in the substantia nigra.According to following standard: Normal echo intensity:Grade I-II.Abnormal echo intensity:Grade III-IV.The one whose SN size exceeding 0.20 cm^2 was considered Abnormal(SN+)and the one below 0.20 cm^2 was normal(SN-).3.Data is collected.The test results were statistically analyzed by using SPSS19.0 software.All data represent by(mean ± standard deviation).It is compared by two independent sample t-test between the two sets of data.The difference test level is made P<0.05.Results 1.the area of SN hyperechogenicity more than 0.20 cm^2 was found in 27 of PD patients,6 of healthy subjects.SN hyperechogenicity area of patients with PD was significantly different from control group,P = 0.000.The sensitivity of TCS in PD was 71.64% and the specificity was 88.24%;the positive predictive value was 85.71% and the classification accuracy was 75.95%.2.There was positive correlation between the area of SN hyperechogenicity and patients' age(P=0.002).There was no correlation between the course of the disease(P=0.561),the score of UPDRS-III(P=0.908)and the severity of condition(P=0.632).Conclusions 1.The incidence of the hyperechoic PD patients was significantly higher than the non-hyperechoic PD patients.TCS can be used for early diagnosis and screening for PD.2.There was correlation between the area of SN hyperechogenicity and patients' age in case group(P=0.002).There was no correlation between the area of SN hyperechogenicity and patients' age in control group(P=0.268).It instructes that late onset age of PD patients more likely to appear SN hyperechogenicity.3.PD patient'with hyperechogenicity of the substantia course of thedisease,UPDRS-III score,Hoehn-Yahr,UPDRS-III score,Hoehn-Yahr Rating Scale do not have a higher score than PD patients' without hyperechogenicity of the substantia(P =0.563,0.908,0.632).The area of SN hyperechogenicity cannot be used to determine the severity of condition on PD.So TCS can be used for early diagnosis and screening of PD,combining to it's safe,cheap,convenient.4.The best critical value of SN hyperechogenicity area of patients with PD and normal controls.is 0.2115cm2,it is very similar to the criteria currently used. |
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