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首页> 外文期刊>Journal of neurology >Transcranial duplex in the differential diagnosis of parkinsonian syndromes: a systematic review.
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Transcranial duplex in the differential diagnosis of parkinsonian syndromes: a systematic review.

机译：经颅双工在帕金森综合症的鉴别诊断：系统的审查。

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BACKGROUND: Transcranial duplex scanning (TCD) of the substantia nigra (SN) is increasingly used to diagnose Idiopathic Parkinson's Disease (IPD). Up until now 70 diagnostic studies have been published, not only on investigation of the SN, but also of the lenticular nucleus (LN) and the Raphe nuclei (RN). METHOD: We systematically reviewed all diagnostic TCD studies in parkinsonian patients up to June 2008. RESULTS: We found 35 eligible studies. Of the 1534 IPD patients investigated in the 35 studies 200 (13%) had an inconclusive SN-TCD. An increased echo-intensity of the SN was seen in 1167 (87%) of the 1334 IPD patients, 276 (12%) of the 2340 healthy controls and in 41 (30%) of the 138 patients with an atypical parkinsonian syndrome (APS). On the contrary, a pathological LNTCD was found more often in APS patients (79%) than in IPD patients (23%) and healthy controls (6%). A decreased echo-intensity of the RN was found more often in depressed (46%) than in non-depressed IPD patients (16%). CONCLUSIONS: SN-TCD accurately differentiates between patients with IPD and healthy controls, but not between patients with IPD and APS. LN-TCD is only moderate accurate to delineate IPD from APS, but combinations of SN- and LN-TCD may be more promising. RN-TCD has only marginal diagnostic accuracy in diagnosing depression in IPD and non-IPD patients. Before TCD can be implicated, more research is needed to standardize the TCD technique, to investigate the TCD in non-research settings and to determine the additional value of TCD compared with currently used clinical techniques like SPECT imaging.
机译：背景：黑质（SN）的经颅双工扫描（TCD）越来越多地用于诊断特发性帕金森氏病（IPD）。到目前为止，已经发表了70篇诊断研究报告，不仅涉及SN的研究，还涉及双凸透镜核（LN）和Raphe核（RN）的研究。方法：我们系统地回顾了截至2008年6月在帕金森氏病患者中进行的所有诊断性TCD研究。结果：我们找到了35项合格研究。在35项研究中调查的1534名IPD患者中，有200名（13％）患有不确定的SN-TCD。在1334名IPD患者中的1167名（87％），2340名健康对照者中的276名（12％）和138名非典型帕金森综合症（APS）患者中的41名（30％）看到了SN的回声强度增加）。相反，APS患者（79％）比IPD患者（23％）和健康对照者（6％）更经常发现病理性LNTCD。与非抑郁型IPD患者（16％）相比，抑郁症（46％）患儿RN回声强度降低的频率更高。结论：SN-TCD能够准确地区分IPD患者和健康对照者，而不是IPD和APS患者。 LN-TCD仅能将ADS中的IPD划定为中等精度，但是SN-和LN-TCD的组合可能更有希望。 RN-TCD在诊断IPD和非IPD患者的抑郁症时仅具有很小的诊断准确性。与目前使用的临床技术（如SPECT成像）相比，在涉及TCD之前，还需要进行更多研究以标准化TCD技术，在非研究环境中研究TCD并确定TCD的附加价值。

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