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DOI: 10.1590/0004-282X20150211
Transcranial sonography: an accurate and reliable diagnostic test for Parkinson’s disease
A ultrassonografia transcraniana como método diagnóstico complementar eficaz e confiável na doença de Parkinson
ABSTRACT
Background: Transcranial sonography (TCS) provides two-dimensional sonographic images of the brain parenchyma through the intact skull. Objective: To determine the accuracy and reliability of TCS and of a novel methodology for echogenicity quantification in post hoc analysis of TCS images for the diagnosis of Parkinson’s disease (PD). Method: 227 participants had standardized TCS examination. Gray scale mean (GSM) of mesencephalic structures was determined from stored images. Results: 10.6% had no bone windows. The groups included 77 PD patients and 126 controls. Substantia nigra (SN) area diagnostic accuracy was 88.0% (85.7% sensibility, 89.7% specificity). For SN > 0.23 cm2, area under the ROC curve = 0.925, Youden index = 0.75, likelihood ratios 8.32 positive and 0.159 negative. The mesencephalic area did not discriminate the groups. Ventricular diameters correlated positively with age and were higher in PD (p = 0.005). Hyperechogenic foci in lentiform nucleus were scarce (2.5%). Reliability and reproducibility of measurements were substantial. GSM showed superior values in Parkinsonians, with good reproducibility. The two methodologies together identified all of the patients, yielding a 100% sensibility. Conclusion: TCS is a reliable and accurate diagnostic tool for PD. The digital image analysis proposed here further enhances its sensibility. TCS has good diagnostic value besides its safety, convenience and low cost.
Tese de Doutorado em Neurologia apresentada à Faculdade de Medicina da Universidade Federal do Rio de Janeiro, 2015.
Orientadores: Maurice Borges Vincent; Ana Lucia Zuma de Rosso; Nordeval Cavalcante Araújo.
Área de concentração: Neurologia.
Conflict of interest:
There is no conflict of interest to declare.
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Publication History
Received: 27 October 2015
Accepted: 18 November 2015
Article published online:
06 September 2023
© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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