在手指主动运动时，对人体腕管内正中神经的位移和变形进行超声评估。
Ultrasound assessment of the displacement and deformation of the median nerve in the human carpal tunnel with active finger motion.
作者信息
Yoshii Yuichi, Villarraga Hector R, Henderson Jacqueline, Zhao Chunfeng, An Kai-Nan, Amadio Peter C
机构信息
Orthopedic Biomechanics Laboratory and Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
出版信息
J Bone Joint Surg Am. 2009 Dec;91(12):2922-30. doi: 10.2106/JBJS.H.01653.
BACKGROUND
Peripheral nerves are mobile structures, stretching and translating in response to changes in the position of adjuvant anatomic structures. The objective of this study was to develop a novel method to characterize the relative motion and deformation of the median nerve on cross-sectional ultrasound images of the carpal tunnel during active finger motion.
METHODS
Fifteen volunteers without a history of carpal tunnel syndrome or wrist trauma were recruited. An ultrasound scanner and a linear array transducer were used to evaluate the motion of the median nerve and the flexor tendons within the carpal tunnel during motion from full extension to full flexion by the four fingers (fist motion) and by the long finger alone. The displacement of the median nerve relative to the long-finger flexor digitorum superficialis tendon as well as the perimeter, cross-sectional area, circularity, and aspect ratio of a minimum enclosing rectangle of the median nerve were measured. The data were compared between single-digit motion and fist motion and between extension and flexion positions.
RESULTS
The distance between the long-finger flexor digitorum superficialis tendon and the median nerve with isolated long-finger flexion was decreased in the ulnar-radial direction and increased in the palmar-dorsal direction as compared with the distance with four-finger flexion (p < 0.01). Compared with the values with fist motion, the aspect ratio was decreased and the circularity was increased with long-finger motion (p < 0.01).
CONCLUSIONS
This report presents a method with which to assess displacement and deformation of the median nerve on a cross-sectional ultrasound image during different finger motions. This method may be useful to assess pathological changes within the carpal tunnel, and we plan to perform a similar study of patients with carpal tunnel syndrome on the basis of these preliminary data.
背景
周围神经是可移动的结构，会随着相邻解剖结构位置的变化而伸展和移位。本研究的目的是开发一种新方法，以在活动手指时腕管的横截面超声图像上表征正中神经的相对运动和变形。
方法
招募了15名无腕管综合征病史或手腕创伤史的志愿者。使用超声扫描仪和线性阵列换能器，评估在四个手指从完全伸展到完全屈曲（握拳动作）以及仅使用示指运动时，腕管内正中神经和屈肌腱的运动。测量正中神经相对于示指浅屈肌腱的位移，以及正中神经最小外接矩形的周长、横截面积、圆形度和长宽比。比较单指运动和握拳运动之间以及伸展和屈曲位置之间的数据。
结果
与四指屈曲时相比，单独示指屈曲时示指浅屈肌腱与正中神经之间在尺桡方向上的距离减小，在掌背方向上的距离增加（p<0.01）。与握拳运动时的值相比，示指运动时的长宽比减小，圆形度增加（p<0.01）。
结论
本报告介绍了一种在不同手指运动期间评估横截面超声图像上正中神经位移和变形的方法。该方法可能有助于评估腕管内的病理变化，并且我们计划基于这些初步数据对腕管综合征患者进行类似研究。
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