Li Xue Yuan, Yu Miao, Zhou Xiao Ling, Li Yi, Chen Hong, Wang Li Ping, Dong Jiang Hui
Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo, 315040, China.
School of Pharmacy and Medical Sciences, and UniSA Cancer Research Institute, University of South Australia, Adelaide, SA 5001, Australia.
Math Biosci Eng. 2019 Mar 15;16(4):2250-2265. doi: 10.3934/mbe.2019111.
Individual variations have been reported in the existing methods for examining peripheral entrapment neuropathy, by which limited sites can be examined. In this study, the patients with unilateral carpal tunnel syndrome (CTS), cubital tunnel syndrome (CuTS) and radial nerve compression (RNC) were selected as research subjects and an ultrasound technique was proposed based on multilevel side-to-side image contrast for the diagnosis of unilateral peripheral entrapment neuropathy. According to the statistical analysis of 62 patients with CTS, CuTS or RNC, the diagnostic thresholds of the cross-sectional area swelling ratio (CSASR) for diagnosis of CTS, CuTS or RNC were 1.22, 1.51 and 1.50, respectively. The surgical therapeutic thresholds of CSASR for the treatment of CTS, CuTS and RNC were 1.48, 1.67 and 3.04, respectively. When the maximal CSASR of the diseased nerve was greater than or equal to the diagnostic threshold, the nerve compression could be diagnosed. If it was less than the diagnostic threshold, nerve compression was excluded. Conservative treatment was indicated when the maximal CSASR of the diseased nerve was less than the therapeutic threshold. When the maximal CSASR was greater than or equal to the therapeutic threshold, surgical treatment was indicated, and the nerve release procedure was selected. The novel multilevel side-to-side image contrast ultrasound technique proposed in this study can substantially reduce the impact of individual variation and explore the full course of the diseased nerve. It is a novel approach for diagnosis, treatment selection, and determination of treatment sites of unilateral peripheral entrapment neuropathy.
已有研究报道，现有用于检查周围神经卡压性神经病的方法存在个体差异，这些方法只能检查有限的部位。在本研究中，选择单侧腕管综合征（CTS）、肘管综合征（CuTS）和桡神经卡压（RNC）患者作为研究对象，提出了一种基于多层面左右对比成像的超声技术，用于诊断单侧周围神经卡压性神经病。根据对62例CTS、CuTS或RNC患者的统计分析，诊断CTS、CuTS或RNC的横截面积肿胀率（CSASR）诊断阈值分别为1.22、1.51和1.50。治疗CTS、CuTS和RNC的CSASR手术治疗阈值分别为1.48、1.67和3.04。当患病神经的最大CSASR大于或等于诊断阈值时，可诊断为神经卡压。如果小于诊断阈值，则排除神经卡压。当患病神经的最大CSASR小于治疗阈值时，建议保守治疗。当最大CSASR大于或等于治疗阈值时，建议手术治疗，并选择神经松解手术。本研究提出的新型多层面左右对比成像超声技术可大幅降低个体差异的影响，全面观察患病神经的全程。它是一种用于诊断、治疗选择和确定单侧周围神经卡压性神经病治疗部位的新方法。
