Blijham Paul J, Hengstman Gerald J D, Ter Laak Henk J, Van Engelen Baziel G M, Zwarts Machiel J
Department of Clinical Neurophysiology, Institute of Neurology, University Medical Centre Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
Muscle Nerve. 2004 Jan;29(1):46-50. doi: 10.1002/mus.10519.
Combinations of different techniques can increase the diagnostic yield from neurophysiological examination of muscle. In 25 patients with suspected inflammatory myopathy, we prospectively performed needle electromyography (EMG) and measured muscle-fiber conduction velocity (MFCV) in a single muscle, using a technique with direct muscle-fiber stimulation and recording. Results of MFCV were compared with final diagnosis, EMG, and needle muscle biopsy. Diagnostic accuracy of combined MFCV and EMG studies was 72%, compared to 60% for EMG alone. This improvement was due to a gain in specificity. The MFCV did not prove useful in discriminating inflammatory myopathy from other myopathies. Furthermore, we found a correlation of 92% between variability of MFCV and myopathic changes in muscle biopsy. We conclude that the utility of electrodiagnostic examination can be increased if EMG examination is combined with MFCV studies.
不同技术的联合应用可提高肌肉神经生理学检查的诊断阳性率。在25例疑似炎性肌病的患者中，我们前瞻性地进行了针电极肌电图（EMG）检查，并采用直接肌肉纤维刺激和记录技术，在单块肌肉中测量肌肉纤维传导速度（MFCV）。将MFCV的结果与最终诊断、EMG以及肌肉针吸活检结果进行比较。MFCV和EMG联合研究的诊断准确率为72%，而单独EMG的诊断准确率为60%。这种提高归因于特异性的增加。MFCV在鉴别炎性肌病与其他肌病方面并无作用。此外，我们发现MFCV的变异性与肌肉活检中的肌病性改变之间存在92%的相关性。我们得出结论，如果将EMG检查与MFCV研究相结合，电诊断检查的效用可以提高。
