ABSTRACT
Objetivo. Describir la prevalencia de la hiperecogenicidad de la sustancia negra en dos muestras de pacientes, unos con diagnóstico de enfermedad de Parkinson (EP) según los criterios de la United Kingdom Parkinsons Disease Society, y una población control, con el fin de establecer los propios valores de referencia para nuestro laboratorio de neurosonología. Sujetos y métodos. Se seleccionaron dos muestras de pacientes compuestos por controles sanos sin enfermedad neurodegenerativa y pacientes con EP. Se realizaron mediciones planimétricas del área de ecogenicidad de la sustancia negra en ambos grupos. Se consideró la mayor área de ecogenicidad medida en cada lado en cada paciente. Se realizaron estadísticos descriptivos de la muestra. Se construyó la curva ROC para mostrar la precisión global, la sensibilidad y la especificidad del Doppler transcraneal en comparación con el diagnóstico clínico de EP. Resultados. Se analizaron en total 45 pacientes con EP y 91 controles. Empleando nuestro propio punto de co e (percentil 90 de los controles = 0,22 cm2), presentaban hiperecogenicidad de la sustancia negra un 73,33% de los pacientes con EP y un 8,79% de los controles (p = 0). Se pudo apreciar un área bajo la curva del 93%, lo que expresa una buena precisión global del Doppler transcraneal en el diagnóstico de EP. Conclusiones. La evaluación ultrasonográfica de la sustancia negra consigue detectar en nuestro laboratorio diferencias significativas entre los sujetos con EP y los sujetos normales. Los valores obtenidos en nuestro laboratorio están ligeramente por debajo de los establecidos como referencia internacional, y ofrecen unos excelentes valores de especificad y una aceptable sensibilidad en nuestro medio (AU)
Aim. To describe the prevalence of hyperechogenicity of the substantia nigra in two samples of patients: one group who had been diagnosed with Parkinsons disease (PD) in accordance with United Kingdom Parkinsons Disease Society criteria and a control population, so as to be able to establish the reference values for our neurosonology laboratory Subjects and methods. Two samples of patients consisting of healthy controls with no neurodegenerative disease and patients with PD were selected. Planimetric measurements of the area of echogenicity in the substantia nigra were performed in both groups. The greatest area of echogenicity measured on each side of each patient was considered. Descriptive statistics of the sample were carried out. The ROC curve was constructed in order to show the overall precision, sensitivity and specificity of transcranial Doppler ultrasonography in comparison to the clinical diagnosis of PD. Results. Altogether 45 patients with PD and 91 controls were analysed. Using our own cut-off point (percentile 90 of the controls = 0.22 cm2), hyperechogenicity of the substantia nigra was observed in 73.33% of patients with PD and 8.79% of the controls (p = 0). An area below the curve of 93% was seen, which represents good overall precision for transcranial Doppler ultrasonography in the diagnosis of PD. Conclusions. The evaluation of the substantia nigra conducted in our laboratory using ultrasound imaging reveals significant differences between subjects with PD and normal subjects. The values obtained in our laboratory are slightly below those established as an international reference and offer excellent values for specificity and an acceptable level of sensitivity in our locale (AU)
Subject(s)
Humans , Substantia Nigra , Ultrasonography, Doppler, Transcranial/methods , Parkinson Disease/physiopathology , Movement DisordersABSTRACT
AIM. To describe the prevalence of hyperechogenicity of the substantia nigra in two samples of patients: one group who had been diagnosed with Parkinson's disease (PD) in accordance with United Kingdom Parkinson's Disease Society criteria and a control population, so as to be able to establish the reference values for our neurosonology laboratory. SUBJECTS AND METHODS. Two samples of patients consisting of healthy controls with no neurodegenerative disease and patients with PD were selected. Planimetric measurements of the area of echogenicity in the substantia nigra were performed in both groups. The greatest area of echogenicity measured on each side of each patient was considered. Descriptive statistics of the sample were carried out. The ROC curve was constructed in order to show the overall precision, sensitivity and specificity of transcranial Doppler ultrasonography in comparison to the clinical diagnosis of PD. RESULTS. Altogether 45 patients with PD and 91 controls were analysed. Using our own cut-off point (percentile 90 of the controls = 0.22 cm2), hyperechogenicity of the substantia nigra was observed in 73.33% of patients with PD and 8.79% of the controls (p = 0). An area below the curve of 93% was seen, which represents good overall precision for transcranial Doppler ultrasonography in the diagnosis of PD. CONCLUSIONS. The evaluation of the substantia nigra conducted in our laboratory using ultrasound imaging reveals significant differences between subjects with PD and normal subjects. The values obtained in our laboratory are slightly below those established as an international reference and offer excellent values for specificity and an acceptable level of sensitivity in our locale.
