Stellenwert der Hirnparenchym-Sonografie in der Differenzial- und Frühdiagnose des Parkinson-Syndroms

Zusammenfassung

Die transkranielle sonografische Untersuchung des Hirnparenchyms stellt einen wichtigen Baustein in der Diagnose und Differenzialdiagnose des Parkinson-Syndroms dar. Bei bis zu 90 % der Parkinson-Patienten ist eine Hyperechogenität der Substantia nigra nachweisbar. Insbesondere in der Frühdiagnose, d. h. bei noch wenig ausgeprägtem klinischen Befund, und in der Differenzialdiagnose zur Multisystematrophie vom Parkinson-Typ (MSA-P) und zur progressiven supranukleären Paralyse (PSP) kann sie wertvolle ergänzende Informationen liefern. Aufgrund der Prävalenz von ca. 10 % in der Normalbevölkerung ist der Nachweis einer Hyperechogenität jedoch nur im Kontext der klinischen Untersuchung anzuwenden. Unterschiedliche Studien weisen darauf hin, dass bei einzelnen Gesunden mit diesem Ultraschallmerkmal eine Vulnerabilität des nigrostriatalen Systems vorliegen kann. Die genaue Bedeutung der Hyperechogenität bei gesunden Personen ist noch Gegenstand der Forschung.

Abstract

Imaging of the brain structure with transcraniel ultrasound has become an important tool for the diagnosis and differential diagnosis of Parkinson's Disease. In up to 90 % of parkinsonian patients abnormal echogenity of the substantia nigra could be demonstrated. Particularly in the early diagnosis in subjects with only very mild extrapyramidal features and in the differential diagnosis to other neurodegenerative disorders with parkinsonian features, such as the parkinsonian variant of multisystematrophy (MSA-P) and progressive supranuclear paralysis (PSP) ultrasound has a high diagnostic yield. Because of a prevalence of about 10 % in the normal population, the evidence of an abnormal echogenity of the substantia nigra has to be interpreted carefully in the context of a clinical examination. Although there are a number of studies indicating that in some of these subjects a vulnerability of the nigrostriatal system can be found, the meaning of an abnormal echogenicity of the substantia nigra in the healthy population needs to be further elucidated in already ongoing research projects.

Schlüsselwörter

Ultraschall - Parkinson-Syndrom - Substantia nigra

Keywords

ultrasound - Parkinsonian-syndrome - substantia nigra

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