Dataset Information

Evaluating a Patient with Transcranial Sonography to Look for Echogenicity.

ABSTRACT: In the last decades, transcranial sonography has been proven to be a useful imaging method in the field of movement disorders. In the clinical routine, structures that are easy to evaluate are the mesencephalic brainstem, including the mesencephalic midline raphe and the substantia nigra in the mesencephalic scanning plane; and the third ventricle, lateral ventricles, basal ganglia, and thalamus in the third ventricular scanning plane. In this video S1, we demonstrate the sonographic assessment of a healthy individual and a patient with Parkinson's disease, visualize how the main structures look, and discuss the assessment. In both individuals, we focus on the planimetric measurement of the substantia nigra.

SUBMITTER: Yilmaz R

PROVIDER: S-EPMC6353370 | biostudies-literature | 2017 Nov-Dec

REPOSITORIES: biostudies-literature

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Evaluating a Patient with Transcranial Sonography to Look for Echogenicity.

Yilmaz Rezzak R Berg Daniela D

Movement disorders clinical practice 20170528 6

In the last decades, transcranial sonography has been proven to be a useful imaging method in the field of movement disorders. In the clinical routine, structures that are easy to evaluate are the mesencephalic brainstem, including the mesencephalic midline raphe and the substantia nigra in the mesencephalic scanning plane; and the third ventricle, lateral ventricles, basal ganglia, and thalamus in the third ventricular scanning plane. In this video S1, we demonstrate the sonographic assessment ...[more]

PMID: 30713988

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Project description:BackgroundHyperechogenicity of the substantia nigra (SN+), detected by transcranial sonography (TCS), was reported as a characteristic finding in Parkinson's disease (PD), with high diagnostic accuracy values, when compared mainly to healthy controls or essential tremor (ET) group. However, some data is accumulating that the SN + could be detected in other neurodegenerative and even in non-neurodegenerative disorders too. Our aim was to estimate the diagnostic accuracy of TCS, mainly focusing on the specificity point, when applied to a range of the parkinsonian disorders, and comparing to the degenerative cognitive syndromes.MethodsA prospective study was carried out at the Hospital of Lithuanian University of Health Sciences from January until September 2011. Initially, a TCS and clinical examination were performed on 258 patients and 76 controls. The General Electric Voluson 730 Expert ultrasound system was used. There were 12.8% of cases excluded with insufficient temporal bones, and 4.3% excluded with an unclear diagnosis. The studied sample consisted of the groups: PD (n = 71, 33.2%), ET (n = 58, 27.1%), PD and ET (n = 10, 4.7%), atypical parkinsonian syndromes (APS) (n = 3, 1.4%), hereditary neurodegenerative parkinsonism (HDP) (n = 3, 1.4%), secondary parkinsonism (SP) (n = 23, 10.8%), mild cognitive impairment (MCI) (n = 33, 15.4%), dementia (n = 13, 6.1%), and control (n = 71).ResultsThere were 80.3% of PD patients at stages 1 & 2 according to Hoehn and Yahr. At the cut-off value of 0.20 cm² of the SN+, the sensitivity for PD was 94.3% and the specificity - 63.3% (ROC analysis, AUC 0.891), in comparison to the rest of the cohort. At the cut-off value of 0.26 cm², the sensitivity was 90% and the specificity 82.4%.The estimations for the lowest specificity for PD, in comparison to the latter subgroups (at the cut-off values of 0.20 cm² and 0.26 cm², respectively) were: 0% and 33.3% to APS, 33.3% and 66.7% to HDP, 34.8% and 69.6% to SP, 55.2% and 82.8% to ET, 75% and 91.7% to dementia.ConclusionsThe high sensitivity of the test could be employed as a valuable screening tool. But TCS is more useful as a supplementary diagnostic method, due to the specificity values not being comprehensive.

Dataset Information

Evaluating a Patient with Transcranial Sonography to Look for Echogenicity.

Publications

Evaluating a Patient with Transcranial Sonography to Look for Echogenicity.

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