超声在腓总神经病变诊断和治疗中的应用。
Ultrasound in the diagnosis and management of fibular mononeuropathy.
机构信息
Center for Neurological Restoration, Cleveland Clinic Foundation, Cleveland, Ohio.
Neuromuscular Center, Neurological Institute, Cleveland Clinic Foundation, Cleveland, Ohio.
出版信息
Muscle Nerve. 2019 Nov;60(5):544-548. doi: 10.1002/mus.26652. Epub 2019 Aug 8.
INTRODUCTION
Ultrasound (US) evaluation of peripheral nerves is a noninvasive, cost-effective approach to diagnosing focal mononeuropathies and guiding surgical management. We used the intranerve ratio to evaluate for possible cut-off values in diagnosis of fibular mononeuropathies (FNs).
METHODS
A retrospective analysis of FN confirmed by electrodiagnosis (EDx) was performed to identify intranerve ratio values between affected and unaffected limbs at the fibular head and popliteal fossa.
RESULTS
The optimal fibular head/popliteal fossa intranerve ratio to discriminate between limbs with and without disease was 1.25 (sensitivity, 51%; specificity, 71%). There was no statistically significant difference between affected vs unaffected limbs (ratio, 1.13; P = .15) nor in subgroup analyses. However, 25% of patients had structural lesions amenable to surgery.
DISCUSSION
The utility of US in diagnosis of FN is limited using intranerve ratio data, but US has a distinct advantage over EDx for identifying treatable structural lesions.
简介
超声（US）检查外周神经是非侵入性、经济有效的方法，可用于诊断局灶性单神经病，并指导手术治疗。我们使用神经内比值来评估腓总神经病（FN）的诊断可能的截断值。
方法
对经电诊断（EDx）证实的 FN 进行回顾性分析，以确定腓骨头和腘窝处受累和未受累肢体的神经内比值。
结果
区分有病变和无病变肢体的最佳腓骨头/腘窝神经内比值为 1.25（敏感性 51%，特异性 71%）。受累与未受累肢体之间的比值无统计学差异（比值 1.13；P =.15），亚组分析也无差异。然而，25%的患者存在可手术治疗的结构性病变。
讨论
使用神经内比值数据，超声在 FN 诊断中的应用有限，但超声在识别可治疗的结构性病变方面明显优于 EDx。
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