Letissier Hoel, Dardenne Guillaume, Saraux Alain, Le Nen Dominique, Borotikar Bhushan, Jousse-Joulin Sandrine
Service de Chirurgie Orthopédique et Traumatologique, Hôpital de la Cavale Blanche, Boulevard Tanguy Prigent, 29200, Brest, France.
LaTIM, INSERM, UMR 1101, SFR IBSAM, Avenue Foch, 29200, Brest, France.
Rheumatol Ther. 2021 Mar;8(1):457-466. doi: 10.1007/s40744-021-00283-2. Epub 2021 Feb 4.
Ulnar tunnel syndrome at the elbow is a common pathology. The ultrasound cross-sectional area is a well-known metric widely accepted in radiology for the description of nerve entrapment. However, the pathological cut-off value remains challenging. The objectives of this study were to (1) describe the ultrasound cross-sectional area measurement of the ulnar nerve at three locations, and (2) to evaluate the inter-observer reliability by two independent ultrasonographers.
One-hundred ulnar nerves of 50 asymptomatic individuals were scanned using B-mode and power Doppler ultrasonography. The ultrasound cross-sectional area measurements of the ulnar nerve were performed at three different levels: 2 cm proximal to the epicondyle, at the level of the epicondyle, and 2 cm distal to the epicondyle.
In our healthy population, we found 21, 24 and 7% of ultrasound cross-sectional area ulnar nerve > 8 mm, respectively, at three different levels of measurement and 4, 7, and 0% US-CSA ulnar nerve > 10 mm. The intraclass correlation coefficient measured at three different site levels were good (0.7943, 0.7509) to moderate (0.5701).
Almost one-quarter of our healthy population had an ultrasound cross-sectional area ulnar nerve more than 8 mm and few more than 10 mm. A cut-off of ultrasound cross-sectional area ulnar nerve measurement more than 10 mm could be considered as pathological. No abnormal elbow ulnar nerve vascularization has been seen. This is the first step towards normal B-mode ulnar nerve values at the elbow to further detect pathological US findings as ulnar nerve entrapment.
肘部尺神经沟综合征是一种常见的病理状况。超声横截面积是放射学中广泛接受的用于描述神经卡压的指标。然而,病理截断值仍然具有挑战性。本研究的目的是:(1)描述尺神经在三个位置的超声横截面积测量;(2)评估两名独立超声检查医师之间的观察者间可靠性。
使用B型和能量多普勒超声对50名无症状个体的100条尺神经进行扫描。在三个不同水平进行尺神经的超声横截面积测量:肱骨髁上2厘米处、肱骨髁水平以及肱骨髁下2厘米处。
在我们的健康人群中,在三个不同测量水平上,分别有21%、24%和7%的尺神经超声横截面积大于8毫米,4%、7%和0%的尺神经超声横截面积大于10毫米。在三个不同部位水平测量的组内相关系数良好(0.7943,0.7509)至中等(0.5701)。
在我们的健康人群中,近四分之一的人的尺神经超声横截面积超过8毫米,超过10毫米的人较少。尺神经超声横截面积测量超过10毫米的截断值可被视为病理性的。未观察到肘部尺神经有异常血管形成。这是确定肘部正常B型尺神经值的第一步,以便进一步检测如尺神经卡压等病理性超声表现。