RT, RVS, The Ohio State University, 453 W 10th Ave, Columbus, OH 43210 USA.
J Ultrasound Med. 2014 Jan;33(1):103-9. doi: 10.7863/ultra.33.1.103.
The purpose of this study was to provide clinical evidence of the use of contrast-enhanced sonography in detecting and quantifying changes in intraneural vascularity due to median mononeuropathy.
Five Macaca fascicularis monkeys were exposed to 20 weeks of repetitive work to increase their risk of developing median mononeuropathy. Contrast-enhanced sonograms were obtained in 30-second increments for 7 minutes while a contrast agent was being delivered. Data were collected immediately at the conclusion of the 20-week work exposure and then again during a recovery phase approximately 3 months after the completion of work. Quantitative analysis and trend graphs were used to analyze median nerve perfusion intensity. This study also compared the use of both manual counting of pixels and semiautomatic measurement using specialized software.
Based on the average data, maximum intensity values were identified as the best indicators of nerve hyperemia. Paired t tests demonstrated significantly higher maximum intensities in the working stage for 4 of the 5 subjects (P < .01).
This study provides preliminary evidence that (1) in a controlled exposure model, a change in intraneural vascularity of the median nerve between working and recovery can be observed; (2) this vascular change can be measured using an objective technique that quantifies the intensity of vascularity; and (3) contrast-enhanced sonography may improve the ability to reliably capture and measure low-flow microvascularity.
本研究旨在提供临床证据，证明对比增强超声在检测和量化正中神经单神经病引起的神经内血管变化方面的作用。
将 5 只食蟹猴暴露于 20 周的重复性工作中，以增加其发生正中神经单神经病的风险。在注射对比剂的同时，以 30 秒为间隔进行 7 分钟的对比增强超声检查。在 20 周工作暴露结束时立即收集数据，然后在工作完成约 3 个月后的恢复期再次收集数据。使用定量分析和趋势图分析正中神经灌注强度。本研究还比较了手动计数像素和使用专用软件进行半自动测量的两种方法。
根据平均数据，最大强度值被确定为神经充血的最佳指标。配对 t 检验显示，5 名受试者中有 4 名在工作阶段的最大强度显著升高（P <.01）。
本研究初步证明：（1）在受控暴露模型中，可以观察到正中神经内神经血管变化在工作和恢复之间的变化；（2）可以使用客观技术测量这种血管变化，该技术可以量化血管密度；（3）对比增强超声可能提高可靠捕获和测量低流速微血管的能力。
