Zhang Li, Rehemutula Aierken, Peng Feng, Yu Cong, Wang Tian-Bin, Chen Lin
Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China ; Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China ; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China.
Department of Orthopedics, Beijing University People's Hospital, Beijing, China.
Neural Regen Res. 2015 Jul;10(7):1172-6. doi: 10.4103/1673-5374.160117.
Although ultrasound measurements have been used in previous studies on carpal tunnel syndrome to visualize injury to the median nerve, whether such ultrasound data can indicate the severity of carpal tunnel syndrome remains controversial. The cross-sectional areas of the median nerve at the tunnel inlet and outlet can show swelling and compression of the nerve at the carpal. We hypothesized that the ratio of the cross-sectional areas of the median nerve at the carpal tunnel inlet to outlet accurately reflects the severity of carpal tunnel syndrome. To test this, high-resolution ultrasound with a linear array transducer at 5-17 MHz was used to assess 77 patients with carpal tunnel syndrome. The results showed that the cut-off point for the inlet-to-outlet ratio was 1.14. Significant differences in the inlet-to-outlet ratio were found among patients with mild, moderate, and severe carpal tunnel syndrome. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.29 between mild and more severe (moderate and severe) carpal tunnel syndrome patients with 64.7% sensitivity and 72.7% specificity. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.52 between the moderate and severe carpal tunnel syndrome patients with 80.0% sensitivity and 64.7% specificity. These results suggest that the inlet-to-outlet ratio reflected the severity of carpal tunnel syndrome.
尽管在先前关于腕管综合征的研究中已使用超声测量来观察正中神经损伤情况，但此类超声数据能否表明腕管综合征的严重程度仍存在争议。腕管入口和出口处正中神经的横截面积可显示腕部神经的肿胀和受压情况。我们假设腕管入口与出口处正中神经横截面积之比能准确反映腕管综合征的严重程度。为验证这一点，我们使用5 - 17兆赫的线性阵列换能器进行高分辨率超声检查，对77例腕管综合征患者进行评估。结果显示，入口与出口面积比的临界点为1.14。在轻度、中度和重度腕管综合征患者中，入口与出口面积比存在显著差异。轻度与更严重（中度和重度）腕管综合征患者之间，正中神经横截面积比的临界点为1.29，敏感性为64.7%，特异性为72.7%。中度与重度腕管综合征患者之间，正中神经横截面积比的临界点为1.52，敏感性为80.0%，特异性为64.7%。这些结果表明，入口与出口面积比反映了腕管综合征的严重程度。
