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Abstract：
The utility of transcranial sonography (TCS) remains unclarified for the auxiliary diagnosis of Parkinson\'s disease (PD). We investigated iodine-123 metaiodobenzylguanidine (MIBG) and TCS during the examination and diagnosis of high-signal-intensity substantia nigra lesion (HSI-SNL) incidence in PD patients previously diagnosed with dopamine transporter scintigraphy (DAT). The subjects were 67 patients with definitively diagnosed PD after DAT evaluation. Patients with midbrain substantia nigra visible during TCS who previously underwent MIBG were analyzed. The SN+ group comprised patients with extensive pathological HSI-SNL of Okawa class III/IV observed during TCS. The MIBG+ group comprised patients with a heart-to-mediastinum ratio of ≤2.2 during MIBG. TCS was performed to divide patients into the SN+ and SN- groups, and patient characteristics and MIBG findings were compared between the groups. PD was definitively diagnosed in 67 patients, among whom midbrain was visualized during TCS in 43 (64.1%) patients and pathological HSI-SNL was observed in 24 (35.8%). The MIBG findings were normal in six patients (27.3%) with HSI-SNL, and abnormal in seven (63.6%) without HSI-SNL. No significant differences were noted by Okawa classification in clinical characteristics based on the presence or absence of HSI-SNL. Multiple patients with normal findings during MIBG may have HSI-SNL. Thus, confirmatory imaging of HSI-SNL with TCS may be useful for diagnosis.
摘要：
经颅超声检查（TCS）对帕金森病（PD）的辅助诊断仍不清楚。我们在先前诊断为多巴胺转运体闪烁显像（DAT）的PD患者的高信号强度黑质病变（HSI-SNL）发生率的检查和诊断过程中，调查了碘123偏碘苄基胍（MIBG）和TCS。受试者为67例DAT评估后明确诊断为PD的患者。分析了先前接受MIBG的TCS期间可见的中脑黑质患者。SN组包括在TCS期间观察到的OkawaIII/IV级广泛病理性HSI-SNL患者。MIBG+组包括MIBG期间心脏与纵隔比率≤2.2的患者。TCS将患者分为SN+和SN-组，并比较两组患者特征和MIBG结果.在67名患者中明确诊断为PD，其中43例(64.1%)患者在TCS期间观察到中脑，24例(35.8%)观察到病理性HSI-SNL。6例HSI-SNL患者（27.3%）的MIBG表现正常，7例(63.6%)无HSI-SNL异常。根据HSI-SNL的存在或不存在，Okawa分类在临床特征上没有发现显着差异。在MIBG期间发现正常的多个患者可能患有HSI-SNL。因此，HSI-SNL与TCS的确诊成像可能有助于诊断.
