Ogur T, Yakut Z I, Teber M A, Alp F, Turan A, Tural A, Gelisen O
Department of Radiology, Oncology Education and Research Hospital, Ankara, Turkey.
Eur Rev Med Pharmacol Sci. 2015 Jan;19(1):23-30.
To evaluate the median nerve (MN) in pregnant women with carpal tunnel syndrome (CTS) by using ultrasound elastography.
30 wrists of 20 pregnant women with CTS and 25 wrists of 14 healthy control pregnant women were evaluated by ultrasound and ultrasound elastography (UE). The MN in the patients' wrist was imaged to measure the cross-sectional area and longitudinally to calculate the elasticity value (EV) at four different locations (proximal carpal tunnel (CT) at the level of the pisiform, distal CT at the level of the hamate, middle of the CT and forearm at one centimeter above the CT). Clinical classification was performed according to a historic and objective scale of CTS. In the healthy pregnant women and pregnant women with CTS, MN area and EV were analyzed statistically by comparing with parity and clinical grade.
There was a statistically significant difference for MN area between the patient and control groups (p = 0.001). A positive relationship was found between parity in pregnancy and clinical grade of the CTS (p = 0.035, Pearson's correlation coefficient = 0.386). Although MN elasticity for both groups was nearly the same in the proximal region of the CT, these values were decreased in the middle of the CT. MN elasticity values were smaller in the distal region of CT, and it was statistically significant in pregnant women with CTS (p = 0.02).
Ultrasound elastography, which is a non-invasive, inexpensive and a favorable diagnosis technique, may be useful in the diagnosis of CTS, especially in conditions in which an invasive procedure would be problem, as in pregnancy.
通过超声弹性成像评估患有腕管综合征（CTS）的孕妇的正中神经（MN）。
对20名患有CTS的孕妇的30只手腕以及14名健康对照孕妇的25只手腕进行超声和超声弹性成像（UE）评估。对患者手腕处的MN进行成像以测量横截面积，并纵向测量以计算四个不同位置（豌豆骨水平的近端腕管（CT）、钩骨水平的远端CT、CT中部以及CT上方1厘米处的前臂）的弹性值（EV）。根据CTS的历史和客观量表进行临床分级。在健康孕妇和患有CTS的孕妇中，通过与孕周和临床分级进行比较，对MN面积和EV进行统计学分析。
患者组和对照组之间的MN面积存在统计学显著差异（p = 0.001）。发现孕期孕周与CTS的临床分级之间存在正相关关系（p = 0.035，Pearson相关系数 = 0.386）。尽管两组在CT近端区域的MN弹性几乎相同，但这些值在CT中部降低。CT远端区域的MN弹性值较小，在患有CTS的孕妇中具有统计学显著性（p = 0.02）。
超声弹性成像作为一种非侵入性、廉价且良好的诊断技术，可能在CTS的诊断中有用，尤其是在像怀孕这样进行侵入性操作会有问题的情况下。
