• 四川大學華西醫(yī)院神經內科（成都，610041）;

【摘要】　 帕金森病（Parkinson′s disease，PD）早期臨床表現多不典型，早期診斷、早期神經保護治療有可能延緩病程進展。經顱超聲成像（transcranial sonography， TCS） 是一種新型的非侵入性超聲成像技術，可早期發(fā)現PD 患者的黑質區(qū)回聲增強這一特性，同時黑質回聲與病程無關；根據其黑質回聲的特征性改變，可對PD患者進行早期診斷。現結合近年國內外研究，對 TCS在早期PD診斷中的價值進行綜述。

引用本文： 趙東梅,暢雪麗,彭蓉. 經顱超聲成像在早期帕金森病診斷中的價值. 華西醫(yī)學, 2011, 26(10): 1585-1588. doi: 復制

版權信息： ?四川大學華西醫(yī)院華西期刊社《華西醫(yī)學》版權所有，未經授權不得轉載、改編

1. 　Riederer P, Wuketich S. A detailed study of influential factors in human brain amine analysis[J]. Neural Transm, 1976, 38(34): 277-301.
2. 　Berg D. Transcranial ultrasound as a risk marker for Parkinson′s disease[J]. Mov Disord, 2009, 24(2): 677-683.
3. 　Becker G, Seufert J, Bogdahn U, et al. Degeneration of substantia nigra in chronic Parkinson′s disease visualized by transcranial-color-coded real-time sonography[J]. Neurology, 1995, 45(1): 182-184.
4. 　Berg D. In vivo detection of iron and neuromelanin by transcranial sonography-a new approach for early detection of substantia nigra damage[J]. Neural Transm, 2006, 113(6): 775-780.
5. 　Berg D, Godau J, Walter U. Transcranial sonography in movement disorders[J]. Lancet Neurol, 2008, 7(11): 1044-1055.
6. 　Walter U, Dressler D, Wolters A, et al. Transcranial brain sonography fndings in clinical subgroups of idiopathic Parkinson′s disease[J]. Mov Disord, 2007, 22(1): 48-54.
7. 　Berg D, Siefker C, Becker G. Echogenicity of the substantia nigra in Parkinson′s disease and its relation to clinical fndings[J]. Neurol, 2001, 248(8): 684-689.
8. 　Skoloudik D, Bartova P, Herzog R. Trancranial sonography in Parkinson′s disease[J]. Aging Health, 2009, 5(1): 43-49.
9. 　Okawa M, Miwa H, Kajimoto Y, et al. Transcranial sonography of the substantia nigra in Japanese patients with Parkinson′s disease oratypical parkinsonism: clinical potential and limitations[J]. Intern Med, 2007, 46 (18): 1527-1530.
10. 　Becker G, Seufert J, Bogdahn U, et al. Degeneration of substantia nigra in chronic Parkinson′s disease visualized by transcranial color-coded real-time sonography[J]. Neurology, 1995, 45(1): 182-184.
11. 　Gaenslen A, Unmuth B, Godau J, et al. The specificity and sensitivity of transcranial ultrasound in the differential diagnosis of Parkinson′sdisease: a prospective blinded study[J]. Lancet Neurol, 2008, 7(5): 417-424.
12. 　Berg D, Merz B, Reiners K, et al. Five-year follow-up study of hyperechogenicity of the substantia nigra in Parkinson′s disease[J]. Mov Disord, 2005, 20(4): 383-388.
13. 　Berg D, Siefker C, Ruprecht-Dorfler P, et al. Relationship of substantia nigra echogenicity and motor function in elderly subjects[J]. Neurology, 2001, 56(1): 13-17.
14. 　Behnke S, Double KL, Duma S, et al. Substantia nigra echomorphology in the healthy very old: correlation with motor slowing[J]. Neuroimage, 2007, 34(11): 1054-1055.
15. 　Ruprecht-Dorfler P, Berg D, Tucha O, et al.Echogenicity of the substantia nigra in relatives of patients with sporadic Parkinson′s Disease[J]. Neuroimage, 2003, 18(4): 416-422.
16. 　Walter U, Wittstock M, Benecke R, et al. Substantia nigraechogenicity is normal in non-extrapyramidal cerebral disordersbut increased in Parkinson′s disease[J]. Neural Transm, 2002, 109(2): 191-196.
17. 　Berg D, Roggendorf W, Schroder U, et al. Echogenicity of the substantia nigra: associationwith increased iron content and marker for susceptibility to nigrostriatal injury[J]. Arch Neurol, 2002, 59(10): 999-1005.
18. 　Berg D, Becker G, Zeiler B, et al. Vulnerability of the nigrostriatal system asdetected by transcranial ultrasound[J]. Neurology, 1999, 53(11): 1026-1031.
19. 　Budisic M, Trkanjec Z, Bosnjak J, et al. Distinguishing Parkinson′s disease and essential tremor with transcranial Sonography[J]. Acta Neurol Scand, 2009, 119(1): 17-21.
20. 　陳靜. 經顱超聲輔助診斷震顫為主的早期帕金森病[J]. 山東醫(yī)藥, 2009, 49(16): 58-59.
21. 　陳靜, 孫相如, 黃一寧. 晚發(fā)型帕金森病經顱超聲的表現[J]. 中風與神經疾病雜志, 2009, 26(3): 343-344.
22. 　Behnke S, Berg D, Naumann M, et al. Differentiation of Parkinson′sdisease and a typical Parkinsonian syndromes by transcranial ultrasound[J]. Neurol Neurosurg Psychiatry, 2005, 76(4): 423-425.
23. 　Berg D. Ultrasound in the (premotor) diagnosis of Parkinson′s disease[J]. Parkinsonism Relat Disord, 2007, 13(4): 429-433.
24. 　Walter U, Niehaus L, Probst T, et al. Brain parenchyma sonography discriminates Parkinson′s disease and atypical Parkinsonian syndromes[J]. Neurology, 2003, 60(1): 74-77.
25. 　Walter U, Dressler D, Wolters A, et al. Sonographic discrimination of dementia with Lewy bodies and Parkinson′s disease with dementia[J]. Neurol, 2006, 253(5): 448-454.
26. 　Hochstrasser H, Tomiuk J, Walter U, et al. Functional relevance of ceruloplasmin mutations in Parkinsonism disease[J]. FASEBJ, 2005, 19(20): 185l-1853.
27. 　Bouwmans AE, Vlaar AM, Srulijes K, et al. Transcranial sonography for the discrimination of idiopathic Parkinson′s disease from the atypical parkinsonian syndromes[J]. Int Rev Neurobiol, 2010, 90(1): 121-146.
28. 　Zecea L, Berg D, Arzberger T,et al. in vivo detection of iron and neuromelanin by trameranial sonographya new approach for eayly detection of substantia nigra damage[J]. Mov Disord, 2005, 20(12): 1278-1285.
29. 　Berg D, Hochstrasser H, Schweitzer KJ, et al. Disbance of iron metabolism in Parkinson′s disease: ultrasonography as a biomarker[J]. Neurotox Res, 2006, 9(1): 1-13.
30. 　Akbas N, Hochstrasser H, Deplazes J, et al. Screening formutations of the HFE gene in Parkinson′s disease patients with hyperechogenicity of the substantia nigra[J]. Neurosci Lett, 2006, 407(1): 16-19.
31. 　Lova G, Garmashov A, Andxouchtchenko N, et al. Postnatal decrease in substaraia nigra echogenicity: implications for the pathogenesis of Parkinson′s disease[J]. Neurol, 2004, 251(13): 1451-1454.
32. 　Walter U, Behnke S, Eyding J, et al. Transcranial brain parenchyma sonography in movement disorders: state of the art [J].Ultrasound Med Biol, 2007, 33(1): 15-25.
33. 　Tsai CF, Wu RM, Huang YW, et al. Transcranial color-coded sonography helps differentiation between idiopathic Parkinson′s disease and vascular Parkinsonism[J]. Neurol, 2007, 254(5): 501-508.
  1. 1. 　Riederer P, Wuketich S. A detailed study of influential factors in human brain amine analysis[J]. Neural Transm, 1976, 38(34): 277-301.
  2. 2. 　Berg D. Transcranial ultrasound as a risk marker for Parkinson′s disease[J]. Mov Disord, 2009, 24(2): 677-683.
  3. 3. 　Becker G, Seufert J, Bogdahn U, et al. Degeneration of substantia nigra in chronic Parkinson′s disease visualized by transcranial-color-coded real-time sonography[J]. Neurology, 1995, 45(1): 182-184.
  4. 4. 　Berg D. In vivo detection of iron and neuromelanin by transcranial sonography-a new approach for early detection of substantia nigra damage[J]. Neural Transm, 2006, 113(6): 775-780.
  5. 5. 　Berg D, Godau J, Walter U. Transcranial sonography in movement disorders[J]. Lancet Neurol, 2008, 7(11): 1044-1055.
  6. 6. 　Walter U, Dressler D, Wolters A, et al. Transcranial brain sonography fndings in clinical subgroups of idiopathic Parkinson′s disease[J]. Mov Disord, 2007, 22(1): 48-54.
  7. 7. 　Berg D, Siefker C, Becker G. Echogenicity of the substantia nigra in Parkinson′s disease and its relation to clinical fndings[J]. Neurol, 2001, 248(8): 684-689.
  8. 8. 　Skoloudik D, Bartova P, Herzog R. Trancranial sonography in Parkinson′s disease[J]. Aging Health, 2009, 5(1): 43-49.
  9. 9. 　Okawa M, Miwa H, Kajimoto Y, et al. Transcranial sonography of the substantia nigra in Japanese patients with Parkinson′s disease oratypical parkinsonism: clinical potential and limitations[J]. Intern Med, 2007, 46 (18): 1527-1530.
  10. 10. 　Becker G, Seufert J, Bogdahn U, et al. Degeneration of substantia nigra in chronic Parkinson′s disease visualized by transcranial color-coded real-time sonography[J]. Neurology, 1995, 45(1): 182-184.
  11. 11. 　Gaenslen A, Unmuth B, Godau J, et al. The specificity and sensitivity of transcranial ultrasound in the differential diagnosis of Parkinson′sdisease: a prospective blinded study[J]. Lancet Neurol, 2008, 7(5): 417-424.
  12. 12. 　Berg D, Merz B, Reiners K, et al. Five-year follow-up study of hyperechogenicity of the substantia nigra in Parkinson′s disease[J]. Mov Disord, 2005, 20(4): 383-388.
  13. 13. 　Berg D, Siefker C, Ruprecht-Dorfler P, et al. Relationship of substantia nigra echogenicity and motor function in elderly subjects[J]. Neurology, 2001, 56(1): 13-17.
  14. 14. 　Behnke S, Double KL, Duma S, et al. Substantia nigra echomorphology in the healthy very old: correlation with motor slowing[J]. Neuroimage, 2007, 34(11): 1054-1055.
  15. 15. 　Ruprecht-Dorfler P, Berg D, Tucha O, et al.Echogenicity of the substantia nigra in relatives of patients with sporadic Parkinson′s Disease[J]. Neuroimage, 2003, 18(4): 416-422.
  16. 16. 　Walter U, Wittstock M, Benecke R, et al. Substantia nigraechogenicity is normal in non-extrapyramidal cerebral disordersbut increased in Parkinson′s disease[J]. Neural Transm, 2002, 109(2): 191-196.
  17. 17. 　Berg D, Roggendorf W, Schroder U, et al. Echogenicity of the substantia nigra: associationwith increased iron content and marker for susceptibility to nigrostriatal injury[J]. Arch Neurol, 2002, 59(10): 999-1005.
  18. 18. 　Berg D, Becker G, Zeiler B, et al. Vulnerability of the nigrostriatal system asdetected by transcranial ultrasound[J]. Neurology, 1999, 53(11): 1026-1031.
  19. 19. 　Budisic M, Trkanjec Z, Bosnjak J, et al. Distinguishing Parkinson′s disease and essential tremor with transcranial Sonography[J]. Acta Neurol Scand, 2009, 119(1): 17-21.
  20. 20. 　陳靜. 經顱超聲輔助診斷震顫為主的早期帕金森病[J]. 山東醫(yī)藥, 2009, 49(16): 58-59.
  21. 21. 　陳靜, 孫相如, 黃一寧. 晚發(fā)型帕金森病經顱超聲的表現[J]. 中風與神經疾病雜志, 2009, 26(3): 343-344.
  22. 22. 　Behnke S, Berg D, Naumann M, et al. Differentiation of Parkinson′sdisease and a typical Parkinsonian syndromes by transcranial ultrasound[J]. Neurol Neurosurg Psychiatry, 2005, 76(4): 423-425.
  23. 23. 　Berg D. Ultrasound in the (premotor) diagnosis of Parkinson′s disease[J]. Parkinsonism Relat Disord, 2007, 13(4): 429-433.
  24. 24. 　Walter U, Niehaus L, Probst T, et al. Brain parenchyma sonography discriminates Parkinson′s disease and atypical Parkinsonian syndromes[J]. Neurology, 2003, 60(1): 74-77.
  25. 25. 　Walter U, Dressler D, Wolters A, et al. Sonographic discrimination of dementia with Lewy bodies and Parkinson′s disease with dementia[J]. Neurol, 2006, 253(5): 448-454.
  26. 26. 　Hochstrasser H, Tomiuk J, Walter U, et al. Functional relevance of ceruloplasmin mutations in Parkinsonism disease[J]. FASEBJ, 2005, 19(20): 185l-1853.
  27. 27. 　Bouwmans AE, Vlaar AM, Srulijes K, et al. Transcranial sonography for the discrimination of idiopathic Parkinson′s disease from the atypical parkinsonian syndromes[J]. Int Rev Neurobiol, 2010, 90(1): 121-146.
  28. 28. 　Zecea L, Berg D, Arzberger T,et al. in vivo detection of iron and neuromelanin by trameranial sonographya new approach for eayly detection of substantia nigra damage[J]. Mov Disord, 2005, 20(12): 1278-1285.
  29. 29. 　Berg D, Hochstrasser H, Schweitzer KJ, et al. Disbance of iron metabolism in Parkinson′s disease: ultrasonography as a biomarker[J]. Neurotox Res, 2006, 9(1): 1-13.
  30. 30. 　Akbas N, Hochstrasser H, Deplazes J, et al. Screening formutations of the HFE gene in Parkinson′s disease patients with hyperechogenicity of the substantia nigra[J]. Neurosci Lett, 2006, 407(1): 16-19.
  31. 31. 　Lova G, Garmashov A, Andxouchtchenko N, et al. Postnatal decrease in substaraia nigra echogenicity: implications for the pathogenesis of Parkinson′s disease[J]. Neurol, 2004, 251(13): 1451-1454.
  32. 32. 　Walter U, Behnke S, Eyding J, et al. Transcranial brain parenchyma sonography in movement disorders: state of the art [J].Ultrasound Med Biol, 2007, 33(1): 15-25.
  33. 33. 　Tsai CF, Wu RM, Huang YW, et al. Transcranial color-coded sonography helps differentiation between idiopathic Parkinson′s disease and vascular Parkinsonism[J]. Neurol, 2007, 254(5): 501-508.