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[夏科-马里-图斯病的超声诊断]

[Ultrasound diagnosis of Charcot-Marie-Tooth disease].

作者信息

Noto Yu-ichi

机构信息

Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine.

出版信息

Brain Nerve. 2014 Mar;66(3):237-46.

Abstract

Charcot-Marie-Tooth (CMT) disease is a clinically and genetically heterogeneous group of diseases with over 45 different causative gene mutations identified. Nerve conduction studies are important for the classification and diagnosis of CMT, whereas ultrasound (US) is increasingly used to assess the peripheral nerves of patients with CMT, as a complement to neurophysiological studies. Recent ultrasound assessment reports of peripheral nerves in CMT are summarized here. An ultrasound finding of CMT1A, which is the most common demyelinating subtype of CMT, is characterized by uniform enlargement of peripheral nerves and nerve roots. Patients with CMT1B (MPZ mutation) also have larger nerves than normal subjects do. Peripheral nerves of patients with CMT2, which is an axonal type of CMT, are slightly larger than those of normal subjects. Focal enlargement of nerves at entrapment sites is a characteristic US finding of hereditary neuropathy with liability to pressure palsy. US findings of CMT are thus subtype-specific. Therefore, the assessment of nerve US may become a useful supporting tool for the diagnosis of CMT subtypes.

摘要

夏科-马里-图斯(CMT)病是一组临床和遗传异质性疾病,已确定有超过45种不同的致病基因突变。神经传导研究对CMT的分类和诊断很重要,而超声(US)越来越多地用于评估CMT患者的周围神经,作为神经生理学研究的补充。本文总结了近期CMT周围神经的超声评估报告。CMT1A是CMT最常见的脱髓鞘亚型,其超声表现为周围神经和神经根均匀增粗。CMT1B(MPZ突变)患者的神经也比正常受试者粗大。CMT2是轴索性CMT,其患者的周围神经比正常受试者略粗。卡压部位神经的局灶性增粗是遗传性压力易感性神经病的特征性超声表现。因此,CMT的超声表现具有亚型特异性。所以,神经超声评估可能成为诊断CMT亚型的有用辅助工具。

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