Objective: We aimed to apply digital analysis to quantify hyperechogenicity of Substantia nigra, and explore its clinical value for the diagnosis of PD.

Background: Increased echogenicity of the Substantia nigra (SN) has been widely recognized as a marker of Parkinson’s disease (PD). However, the diagnostic accuracy of transcranial sonography relies on the experience of the doctor， and changes in substantia nigra echo cannot be quantified.

Method: The cross-sectional study which from November 2017 to October 2020 included 652 PD patients and 99 controls. Then, all subjects underwent transcranial sonography in Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology. Finally, we compare the diagnostic accuracy of Substantia nigra hyperechogenicity by using digital analysis with that in a manual measurement in PD. Furthermore, the Receiver operating characteristic curve (ROC) analysis was applied to explore diagnosis value in Parkinson’s disease.

Results: There are 482 subjects including 400 in the PD group and 82 in the healthy control group, from whose quantified results of Substantia nigra hyperechogenicity could be used for analysis. The ROC analysis showed that the authenticity Area Under Curve (AUC) of the quantified larger Substantia nigra hyperechoic region detection for diagnosing PD was 0.858(95%CI:0.805-0.910), the sensitivity was 87.8%, and the specificity was 73.2%. What’s more, among these PD patients, there is no correlation between larger Substantia nigra hyperechogenicity and age, age of onset, course of disease, non-motor symptoms, and motor symptoms (P>0.05).

Conclusion: This is the first study applying digital analysis to quantify the changes in Substantia nigra hyperechogenicity. Then, the result shows that diagnostic accuracy for PD based on digital analysis is consistent with the level of experienced clinicians. This method may have broad application prospects in hospital in the future.

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[2] Becker G, Seufert J, Bogdahn U, et al. Degeneration of substantia nigra in chronic Parkinson’s disease visualized by transcranial color-coded real-time sonography [J]. Neurology, 1995, 45(1): 182-184.
[3] van de Loo S, Walter U, Behnke S, et al. Reproducibility and diagnostic accuracy of substantia nigra sonography for the diagnosis of Parkinson’s disease [J]. J Neurol Neurosurg Psychiatry, 2010, 81(10): 1087-1092.
[4] Walter U, Behnke S, Eyding J, et al. Transcranial brain parenchyma sonography in movement disorders: State of the art [J]. Ultrasound in medicine & biology, 2007, 33(1): 15-25.
[5] Chen L, Hagenah J, Mertins A. Feature analysis for Parkinson’s disease detection based on transcranial sonography image [J]. Medical image computing and computer-assisted intervention : MICCAI International Conference on Medical Image Computing and Computer-Assisted Intervention, 2012, 15(Pt 3): 272-279.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/quantity-detection-of-substantia-nigra-hyperechogenicity-based-on-digital-image-analysis-for-diagnosing-parkinsons-disease/