摘要
目的:探讨高频超声联合剪切波弹性成像对于上肢神经卡压综合征的诊断价值。方法:收集2017年1月-2022年11月于我院收治的行手术治疗的66例上肢神经卡压综合征患者作为观察组,并将其按照疾病严重程度分为轻度组、中重度组,其中腕管综合征43例、轻度组18例、中重度组25例,肘管综合征23例、轻度组12例、中重度组11例,选取同时期66例健康人群作为对照组。所有受试者均行常规超声及剪切波弹性成像检查,在豌豆骨及肘管入口水平分别测量正中神经及尺神经前后径、左右径、横截面面积、杨氏模量。比较各个测量指标在各组间的差异。以临床诊断为金标准,分析高频超声及高频超声联合剪切波弹性成像对上肢神经卡压综合征临床分型价值。结果:观察组正中神经横截面积、杨氏模量均显著高于对照组,差异具有统计学意义(P<0.05);观察组尺神经左右径、横截面积、杨氏模量均显著高于对照组,差异具有统计学意义(P<0.05);中重度组正中神经、尺神经杨氏模量均显著高于轻度组,差异具有统计学意义(P<0.05);高频超声、高频超声联合剪切波弹性成像对腕管综合征临床分型的准确率为65.12%、81.40%,敏感度为61.11%、83.33%,特异度为68.0%、80.0%,精确度为57.89%、75.0%;高频超声、高频超声联合剪切波弹性成像对肘管综合征临床分型的准确率为52.17%、78.26%、敏感度为58.33%、83.33%、特异度为45.45%、72.73%、精确度为53.85%、76.92%。结论:高频超声联合剪切波弹性成像对上肢神经卡压综合征表现出较好的诊断价值,可实现以无创的方式对该疾病做出准确诊断。
Objective:To explore the value of high frequency ultrasound combined with shear wave elastography in the diagnosis of nerve entrapment syndrome of upper limb.Methods:A total of 66 patients with nerve entrapment syndrome of upper limb who were admitted to our hospital for surgical treatment from January 2017 to November 2022 were collected as the observation group,and they were divided into mild group and moderate and severe group according to the severity of the disease,including 43 cases of carpal tunnel syndrome,18 cases in mild group and 25 cases in moderate and severe group,23 cases of cubital tunnel syndrome,12 cases in mild group,11 cases in moderate and severe group.66 healthy people during the same time were selected as the control group.All subjects underwent conventional ultrasound and shear wave elastography,and the anteroposterior diameter,horizontal diameter,cross-sectional area and Young's modulus of median and ulnar nerves were measured at the pisiform bone and cubital tunnel inlet levels,respectively.The differences of parameters were compared among the groups.The clinical diagnosis was regarded as the gold standard to analyze the diagnostic value of high frequency ultrasound alone and high frequency ultrasound combined with shear wave elastography in the clinical classification of upper limb nerve entrapment syndrome.Results:Cross-sectional area and Young's modulus of median nerve in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The horizontal diameter,cross-sectional area,Young's modulus of the ulnar nerve in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).Young's modulus of median nerve,ulnar nerve in moderate and severe group were significantly higher than those in mild groups,and the differences were statistically significant(P<0.05).The accuracy,sensitivity,specificity and accuracy of high frequency ultrasound alone and high frequency ultrasound combined with shear wave elastography for clinical classification of carpal tunnel syndrome were 65.12%and 81.40%,61.11%and 83.33%,68.0%and 80.0%,57.89%and 75.0%,respectively.The accuracy,sensitivity,specificity and accuracy of high frequency ultrasound alone and high frequency ultrasound combined with shear wave elastography for clinical classification of cubital tunnel syndrome were 52.17%and 78.26%,58.33%and 83.33%,45.45%and 72.73%,53.85%and 76.92%,respectively.Conclusion:High frequency ultrasound combined with shear wave elastography shows good diagnostic value for upper limb nerve entrapment syndrome,which can realize accurate diagnosis of the disease in a non-invasive way.
作者
赵艳杰
张淑英
郭晓翡
丁常伟
李梦梦
ZHAO Yan-jie;ZHANG Shu-ying;GUO Xiao-fei;DING Chang-wei;LI Meng-meng(Department of Ultrasound,the Second Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215000,China)
出处
《现代生物医学进展》
CAS
2023年第14期2760-2765,共6页
Progress in Modern Biomedicine
基金
2022年度省部共建放射医学与辐射防护国家重点实验室开放课题(GZK1202206)。
关键词
上肢神经卡压综合征
高频超声
剪切波弹性成像
诊断价值
Nerve entrapment syndrome of upper limb
High frequency ultrasound
Shear wave elastography
Diagnosis value
