Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
J Clin Neurosci. 2021 Apr;86:276-283. doi: 10.1016/j.jocn.2021.01.013. Epub 2021 Feb 20.
We aimed to establish the cross-sectional area (CSA) reference values for peripheral nerves of lower extremities in a healthy Chinese population, and to determine their diagnostic values for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and Charcot-Marie-Tooth disease type1A (CMT1A). One hundred eleven healthy subjects, 15-70 years of age, as well as 104 CIDP patients and 26 CMT1A patients were recruited. CSA at predetermined sites of the tibial, fibular, sciatic and sural nerves was measured. The CSA of the tibial nerve ranged from 10.2 ± 1.9 to 20.7 ± 3.6 mm, and for fibular nerve from 8.4 ± 1.8 to 9.5 ± 1.9 mm. 86% CIDP patients had upper limb nerve enlargement, while only 67% had lower limb nerve enlargement. In CIDP patients with normal upper limb ultrasound, 56% (5/9) would have lower limb nerve enlargement. All CMT1A patients had both upper and lower limb nerve enlargement. Addition of lower limb nerve ultrasound showed no added value in diagnosis of CMT1A, but could be supplementary for CIDP when upper limb ultrasound is normal.
我们旨在建立中国健康人群下肢周围神经横截面积（CSA）的参考值，并确定其对慢性炎症性脱髓鞘性多发性神经病（CIDP）和 Charcot-Marie-Tooth 病 1A 型（CMT1A）的诊断价值。共招募了 111 名 15-70 岁的健康受试者，以及 104 名 CIDP 患者和 26 名 CMT1A 患者。在预定的胫骨、腓骨、坐骨和腓肠神经部位测量 CSA。胫骨神经 CSA 范围为 10.2±1.9 至 20.7±3.6mm，腓骨神经 CSA 范围为 8.4±1.8 至 9.5±1.9mm。86%的 CIDP 患者上肢神经肿大，而只有 67%的患者下肢神经肿大。在超声正常的 CIDP 患者中，56%（5/9）会有下肢神经肿大。所有 CMT1A 患者均有上下肢神经肿大。增加下肢神经超声检查对 CMT1A 的诊断没有额外价值，但在上肢超声正常时可以对 CIDP 进行补充。
