超声弹性成像评估血液透析合并腕管综合征患者的正中神经
Ultrasound elastographic evaluation of the median nerve in hemodialysis with carpal tunnel syndrome.
作者信息
Xin Hua, Hu Hai-Yang, Liu Bin, Liu Xiang, Li Xia, Li Jie
机构信息
Department of Ultrasonography, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, 250021, Shandong, People's Republic of China.
Department of Ultrasonography, Qilu Hospital of Shandong University, 107 Culture Road, Jinan, 250012, Shandong, People's Republic of China.
出版信息
J Med Ultrason (2001). 2017 Jan;44(1):123-131. doi: 10.1007/s10396-016-0733-x. Epub 2016 Aug 3.
PURPOSE
The aim of this study was to compare the elasticity of the median nerve (MN) between hemodialysis (HD) patients without carpal tunnel syndrome (CTS) and with CTS, and to evaluate the diagnostic usefulness of the elasticity of the MN in HD-CTS.
MATERIALS AND METHODS
The MN in 22 HD patients without CTS and 49 HD-CTS patients was studied. The cross-sectional area (CSA) and the elasticity of the MN, which was measured as the subcutaneous fat/median nerve (SF/MN) strain ratio, were evaluated.
RESULTS
The mean SF/MN strain ratio in the groups that had received hemodialysis for 0-5, >5-10, and >10-15 years was 1.4 ± 0.28, 1.7 ± 0.18, and 2.0 ± 0.67, respectively. The mean CSA of the MN in the three groups was 9.9 ± 1.30, 11.6 ± 1.61, and 13.4 ± 2.14 mm, respectively. The presence of CTS was predicted by means of SF/MN strain ratio and CSA cutoff values of 1.8 and 11 mm, respectively. Both the SF/MN strain ratio and the CSA in the patients with CTS were higher than those in the patients without CTS (P < 0.05). The sensitivity and specificity of the SF/MN strain ratio and CSA of the MN were 75 and 92 % and 79.2 and 84 %, respectively.
CONCLUSION
Sonoelastography helps to improve the diagnostic accuracy of the ultrasonographic assessment of CTS.
目的
本研究旨在比较无腕管综合征（CTS）和患有CTS的血液透析（HD）患者正中神经（MN）的弹性，并评估MN弹性在HD-CTS中的诊断价值。
材料与方法
研究了22例无CTS的HD患者和49例HD-CTS患者的MN。评估了MN的横截面积（CSA）以及作为皮下脂肪/正中神经（SF/MN）应变比测量的MN弹性。
结果
接受血液透析0 - 5年、>5 - 10年和>10 - 15年的组中，平均SF/MN应变比分别为1.4±0.28、1.7±0.18和2.0±0.67。三组中MN的平均CSA分别为9.9±1.30、11.6±1.61和13.4±2.14mm。CTS的存在分别通过SF/MN应变比和CSA临界值1.8和11mm进行预测。CTS患者的SF/MN应变比和CSA均高于无CTS患者（P<0.05）。MN的SF/MN应变比和CSA的敏感性和特异性分别为75%和92%以及79.2%和84%。
结论
超声弹性成像有助于提高CTS超声评估的诊断准确性。
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