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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2016; 74(03): 261
DOI: 10.1590/0004-282X20150211
THESIS

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
Rita de Cassia Leite Fernandes
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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.


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transcranial sonography - Parkinson’s disease - substantia nigra - diagnostic accuracy - reproducibility

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.


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Conflict of interest:

There is no conflict of interest to declare.

Address for correspondence

Rita de Cassia Leite Fernandes
Hospital Universitário Clementino Fraga Filho, Serviço de Neurologia; Rua Professor Rodolpho Paulo Rocco, 255 / 10º andar / sala 10E36; 21941-913 Rio de Janeiro RJ
Brasil   

Publication History

Received: 27 October 2015

Accepted: 18 November 2015

Article published online:
06 September 2023

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