帕金森病患者与特发性震颤患者黑质经颅超声检测指标的比较

Differential diagnosis of Parkinson’s disease and essential tremor with transcranial sonography based on receiver operating characteristic curve

摘要:

目的 探索黑质经颅超声（TCS）检测在帕金森病（PD）中的诊断价值。方法 检测58例原发性PD患者和60例特发性震颤（ET）患者的TCS单侧强回声面积，计算双侧黑质强回声总面积与中脑总面积的比值，分析黑质TCS用于诊断原发性PD的灵敏度和特异度。结果 原发性PD患者的黑质强回声面积及黑质强回声总面积占中脑总面积的百分比，与ET患者比较，均具有统计学意义（P＜0.05）。黑质TCS检测用于PD诊断时，ROC曲线下面积为A＝0.801，且当其临界值取0.205时诊断敏感度为74.1%，特异度为76.7%。结论 黑质TCS检测可作为诊断原发性PD的辅助检查之一，且对PD的鉴别诊断具有一定的价值。

Abstract:

Objective To determine the diagnostic value of transcranial sonography (TCS) in diagnosis of Parkinson’s disease (PD). Methods Fifty-eight PD patients and 60 patients with essential tremor (ET) admitted in our hospital from September 2013 to March 2014 were subjected in this study. They all received TCS examination. The area of the substantia nigra hyperechogenicity was measured and its ratio to the area of the whole midbrain area (S/M) was calculated. The sensitivity and specificity of TCS for the diagnosis of PD were determined by receiver operating characteristic (ROC) curve. Results The area of substantia nigra hyperechogenicity and the S/M ratio were greater in PD patients than in ET ones (P＜0.05). When the hyperechogenicity was used in diagnosis of PD, the area under the ROC curve was 0.801. The sensitivity was 74.1%, and the specificity was 76.7% when the critical value was set at 0.205. Conclusion TCS Is one of the valuable auxiliary examinations in diagnosis of idiopathic PD, and also of certain value in the differential diagnosis of PD with ET.