Terlemez Rana, Yilmaz Figen, Dogu Beril, Kuran Banu
Department of Physical Therapy and Rehabilitation, Sisli Hamidiye Etfal Education and Research Hospital, Sisli, Istanbul, Turkey.
Department of Physical Therapy and Rehabilitation, Sisli Hamidiye Etfal Education and Research Hospital, Sisli, Istanbul, Turkey.
Arch Phys Med Rehabil. 2018 Jan;99(1):116-120. doi: 10.1016/j.apmr.2017.09.111. Epub 2017 Oct 5.
To assess the correlation between ultrasonographic and electrodiagnostic findings to determine the localization of the ulnar trapping at the elbow.
Cross-sectional and noninterventional trial.
Physical medicine and rehabilitation department of a teaching hospital.
Patients (N=14) diagnosed with ulnar nerve entrapment using short-segment nerve conduction study.
The elbow area was divided into 4 segments with 2-cm intervals. All patients underwent ultrasonographic and electrodiagnostic examinations.
The nerve conduction velocity (NCV) of each segment was measured. The cross-sectional area (CSA) of the ulnar nerve was measured at 5 levels. The proximal CSA/distal CSA ratio (PDR) was calculated by proportioning the CSA values for each segment. The highest PDR was accepted as a trapping segment, whereas the segment with the lowest NCV was accepted electrophysiologically (provided it was <50m/s).
A total of 80 PDR and NCV measurements were taken from 20 elbows. A statistically significant negative correlation (r=-.554; P<.001) was found between general PDR and NCV values. When we assumed that the NCV value <50m/s as the criterion standard for diagnosis, the cutoff value for the PDR was found to be 1.08, with a sensitivity of 70% and a specificity of 92.5%. The minimum NCV value and the maximum PDR value were mostly seen in the third segment compatible with the cubital tunnel.
Ultrasonography seems to be advantageous because it is more comfortable for the patient and requires shorter time than does electroneuromyography. To our knowledge, this is the first study to detect ulnar nerve entrapment by using not only CSA but also PDR as a ratio method with ultrasound.
评估超声检查结果与电诊断结果之间的相关性，以确定肘部尺神经卡压的部位。
横断面非干预性试验。
一家教学医院的物理医学与康复科。
经短节段神经传导研究诊断为尺神经卡压的患者（N = 14）。
将肘部区域以2厘米的间隔分为4段。所有患者均接受超声检查和电诊断检查。
测量每段的神经传导速度（NCV）。在5个水平测量尺神经的横截面积（CSA）。通过按比例计算各段的CSA值来计算近端CSA/远端CSA比值（PDR）。最高的PDR被视为卡压段，而NCV最低的段在电生理上被视为卡压段（前提是<50m/s）。
从20个肘部共进行了80次PDR和NCV测量。发现总体PDR值与NCV值之间存在统计学显著的负相关（r = -0.554；P <.001）。当我们将NCV值<50m/s作为诊断的标准时，发现PDR的临界值为1.08，敏感性为70%，特异性为92.5%。最低的NCV值和最高的PDR值大多出现在与肘管相符的第三段。
超声检查似乎具有优势，因为它对患者来说更舒适，且比肌电图检查所需时间更短。据我们所知，这是第一项不仅使用CSA，还使用PDR作为超声比值法来检测尺神经卡压的研究。
