Nakashima Yuko, Sunagawa Toru, Shinomiya Rikuo, Ochi Mitsu
Department of Orthopedic Surgery, Hiroshima University Hospital, Hiroshima, Japan.
Department of Orthopedic Surgery, Hiroshima University Hospital, Hiroshima, Japan.
Ultrasound Med Biol. 2014 Jul;40(7):1718-21. doi: 10.1016/j.ultrasmedbio.2013.12.011. Epub 2014 Mar 6.
An hourglass-like constriction is a focal fascicular lesion observed in one or a few places in one or a few fascicles of a peripheral nerve trunk, and usually affects the anterior interosseous (AIN) or posterior interosseous (PIN) nerve. Constrictions have previously been discovered only by surgical exploration, and have been unable to be recognized on pre-operative imaging. We encountered some cases in which the lesion was able to be diagnosed pre-operatively by high-resolution ultrasonography; these findings were then confirmed intra-operatively. Five consecutive cases were included in this study. In three cases with constrictions revealed on pre-operative ultrasound, the findings were confirmed intra-operatively. In the remaining two cases in which no constrictions were detected pre-operatively, no constriction was revealed intra-operatively. High-resolution ultrasonography may play a significant role in the diagnosis of hourglass-like constrictions, and may thus lead to significant changes in treatment strategies for AIN and PIN palsy.
沙漏样狭窄是在周围神经干的一个或几个束中的一个或几个部位观察到的局灶性束性病变，通常影响骨间前神经（AIN）或骨间后神经（PIN）。此前，狭窄仅通过手术探查发现，术前影像学检查无法识别。我们遇到了一些病例，通过高分辨率超声能够在术前诊断出病变；这些发现随后在术中得到证实。本研究纳入了连续5例病例。在术前超声显示有狭窄的3例病例中，术中证实了这些发现。在术前未检测到狭窄的其余2例病例中，术中也未发现狭窄。高分辨率超声可能在沙漏样狭窄的诊断中发挥重要作用，从而可能导致AIN和PIN麻痹治疗策略的重大改变。
