Transcranial sonography in patients with multiple system atrophy and Parkinson’s disease

Abstract

Objectives To compare and contrast the characteristics of transcranial sonography(TCS)inmultiple system atrophy(MSA)and Parkinson’s disease(PD), and to assess the value of TCS in the diagnosis and differential diagnosis between MSA and PD. Methods TCS files were collected in 29 MSA patients and 45 PD patients diagnosedby the Departmentof Movement Disorders and 45 healthy controls.The echogenicity of the substantia nigra and lenticular nucleus, the mesencephalic area and the width of the third ventricle among the three groups were analyzed. Results Among the three groups, the rate of hyperechogenicity of the lenticular nucleus was the highest in the MSA group 79.3%(23/29), with 24.4%(11/45)in the PD group and 22.2%(10/45)in the healthy controls.There were statistical differences between the MSA group and the PD group(χ2=21.37, P<0.01)and also between the MSA group and the healthy control group(χ2=23.26, P<0.01). In contrast, the rate of hyperechogenicity of the substantia nigra was 84.4%(38/45)in the PD group, higher than in the MSA group 13.8%(4/29)and the control group(11.1% or 5/45). There were statistical differences between the MSA group and the PD group(χ2=35.87, P<0.01)and also between the MSA group and the healthy controls(χ2=48.50, P<0.01). The widths of the third ventricle and the mesencephalic areas of the three groups were(7.49±3.09)mm and (4.31±0.59)cm2, respectively, for the MSA group; (5.94±2.36)mm and (4.82±0.84)cm2, respectively, for the PD group; (5.88±2.43)mm and (4.79±0.79)cm2, for the healthy controls.The MSA group had the widest thirdventricle(F=4.10, P=0.02)and smallest mesencephalic area(F=4.68, P=0.01). Conclusions The hyperechogenicity of the substantia nigra and lenticular nucleus, the width of the third ventricle and the size of the mesencephalic area measured by TCS can be important parameters indistinguishing MSA from PD. Key words: Multiple system atrophy; Parkinson’s disease; Sonography