Journal of Diagnostic Imaging in Therapy

Over the past 20 years transcranial B-mode sonography (TCS) of brain parenchyma is being increasingly used as a diagnostic tool in movement disorders. The most widely recognised finding for movement disorders has been an increase in echogenicity of the substantia nigra, an area of the midbrain that is affected in idiopathic Parkinson’s disease (IPD). This finding has enabled a reliable diagnosis of IPD with high predictive values. Other sonographic features such as hypoechogenicity of the brainstem raphe and hyperechogenicity of the lentiform nucleus might help to increase the differential diagnosis of IPD and other movement disorders. In comparison with other neuroimaging modalities such as magnetic resonance imaging (MRI) and computed tomography (CT), TCS can currently be performed with portable machines and has the advantages of non-invasiveness with high resistance to movement artifacts. In distinct brain disorders TCS detects abnormalities that cannot be visualized or can only be visualized with significant effort with other imaging methods. This present update summarizes the current methodological standards and defines the assessment of diagnostically relevant deep brain structures such as substantia nigra, brainstem raphe, basal ganglia and ventricles Journal of Diagnostic Imaging in Therapy. 2014; 1(1): 110-128 Godani et al. ISSN: 2057-3782 (Online) http://dx.doi.org/10.17229/jdit.2014-1113-008 111 for differential diagnosis of IPD and other movement disorders. Finally, we provide detailed information about the advantages and limitations of this novel neuroimaging method.