Takeuchi Mikinobu, Wakao Norimitsu, Hirasawa Atsuhiko, Murotani Kenta, Kamiya Mitsuhiro, Osuka Koji, Takayasu Masakazu
Spine Center, Aichi Medical University Aichi Medical University, Nagakute, Aichi, Japan.
Department of Neurological Surgery, Aichi Medical University Aichi Medical University, Karimata 1-1 Yazako, Nagakute City, Aichi Prefecture, Japan.
Eur Radiol. 2017 Aug;27(8):3467-3473. doi: 10.1007/s00330-016-4704-9. Epub 2017 Jan 3.
This study investigated the diagnostic accuracy of the difference in the cross-sectional areas (CSAs) of affected cervical nerve roots (NRs) for diagnosing cervical radiculopathy (CR).
In total, 102 CR patients and 219 healthy volunteers were examined with ultrasound. The CSA of the cervical NR at each level was measured on the affected side and the contralateral side in CR patients by blinded ultrasonographic technicians. The difference between the CSAs of CR patients and normal volunteers and the difference in the laterality of CSA at the same affected level (ΔCSA) were calculated for each cervical level.
The CSAs of the affected NRs in CR patients were significantly larger than those of the unaffected NRs in CR patients and those of the control group at the C5, C6 and C7 levels (P<0.005). ΔCSA was also significantly larger in the CR group at all levels (P<0.001). A receiver operating characteristic analysis demonstrated that the threshold values were 9.6 mm (CSA) for C5NR and 15 mm for both C6NR and C7NR.
This study revealed that the CSAs of affected NRs were enlarged and that the laterality of the CSA (ΔCSA) was greater in CR patients than in control patients.
• Cervical radiculopathy is diagnosed through ultrasonographic measurement of the CSAs. • The CSAs of affected nerve roots were significantly enlarged. • The ΔCSA in the CR group was significantly higher than in the control group. • Diagnostic CSA and ΔCSA thresholds were identified.
本研究调查了患侧颈神经根横截面积（CSA）差异对诊断神经根型颈椎病（CR）的诊断准确性。
共对102例CR患者和219名健康志愿者进行了超声检查。由经验丰富的超声技师在CR患者的患侧和对侧测量各节段颈神经根的CSA。计算CR患者与正常志愿者CSA的差异以及同一患侧节段CSA的左右差异（ΔCSA）。
在C5、C6和C7节段，CR患者患侧神经根的CSA显著大于CR患者未患侧神经根及对照组（P<0.005）。CR组各节段的ΔCSA也显著更大（P<0.001）。受试者工作特征分析表明，C5神经根的阈值为9.6mm（CSA），C6和C7神经根均为15mm。
本研究表明，CR患者患侧神经根的CSA增大，且CSA的左右差异（ΔCSA）大于对照组患者。
• 通过超声测量CSA诊断神经根型颈椎病。• 患侧神经根的CSA显著增大。• CR组的ΔCSA显著高于对照组。• 确定了诊断CSA和ΔCSA阈值。
