摘要
目的:通过超声实时动态图像评估手指主动屈伸运动过程中正中神经的横向位移来分析腕管综合征(Carpal tun-nel syndrome,CTS)的严重程度,进一步探讨正中神经活动性与神经传导研究的严重程度之间的相关性。方法 :采用PhilipsHD15超声诊断仪对80例CTS患者(41例轻度和39例重度)和103例健康志愿者分别在手指中立伸直位和完全屈曲位测量正中神经与尺动脉之间的垂直距离,计算两者之间距离的差值(即正中神经的横向位移)。结果:CTS各组正中神经的横向位移均小于对照组,差异有统计学意义(P<0.01);正中神经的横向位移与末端运动潜伏期呈正相关、与感觉传导速度呈负相关(P<0.01)。结论:通过手指主动伸屈运动过程中对正中神经横向位移的测量,表明超声可动态显示手指运动过程中正中神经的活动性,腕管内正中神经的横向位移(横向滑动)变化与CTS的存在及其严重程度有关;在手指运动过程中用正中神经的横向滑动模式可以定量评价CTS患者正中神经的功能障碍。
Objective: To analyze the severity of carpal tunnel syndrome(CTS) by evaluating the transverse displacement of the median nerve during the active flexion and extension of the fingers through the real-time ultrasound images, and to further explore the relationship between median nerve activity and the severity of nerve conduction. Methods: The vertical distance between the median nerve and the ulnar artery was measured in 80 CTS patients(41 mild and 39 severe) and 103 healthy volunteers at the extension and flexion positions of the fingers respectively using Philips HD15 ultrasonic diagnosis apparatus, and to calculate the difference between the distances of them(ie, transverse displacement of the median nerve). Results: The transverse displacement of the median nerve in each group of CTS was smaller than that in the control group(P<0.01). The transverse displacement of the median nerve was positively correlated with the distal motor latency and negatively correlated with the sensory conduction velocity(P<0.01). Conclusion: Ultrasound can dynamically show the activity of the median nerve during finger movement by measuring the transverse displacement of the median nerve during the active flexion and extension of the finger. The changes in transverse displacement(ie, transverse slide) of the median nerve in the carpal tunnel were related to the presence and severity of CTS. The transverse sliding patterns of the median nerve during finger movements were demonstrated to be useful for quantitatively evaluating median nerve dysfunction in CTS patients.
作者
公春丽
阚艳敏
杨永娜
GONG Chun-li;KAN Yan-min;YANG Yong-na(Department of Ultrasound,the Affiliated Hospital of North China University of Science and Technology,Tangshan Hebei 063000,China;Emergency Department of Kaiping Hospital,Tangshan Hebei 063000,China)
出处
《中国临床医学影像杂志》
CAS
2019年第2期131-134,143,共5页
Journal of China Clinic Medical Imaging
关键词
腕管综合征
正中神经
超声检查
Carpal tunnel syndrome
Median nerve
Ultrasonography
