超声引导下瘫痪肌肉肌电图：神经刺激的应用。

Ultrasound-guided-electromyography in plegic muscle: Usefulness of nerve stimulation.

机构信息

Dipartimento di Scienze Geriatriche e Ortopediche, Università Cattolica del Sacro Cuore, Rome, Italy.

UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

出版信息

Muscle Nerve. 2023 Mar;67(3):204-207. doi: 10.1002/mus.27727. Epub 2022 Oct 17.

DOI:10.1002/mus.27727

PMID:36172941

Abstract

INTRODUCTION/AIMS: In traumatic nerve lesions (TNLs), motor unit potentials (MUPs) may be difficult to detect in early injury. Ultrasound-guided electromyography (US-EMG) can aid in identifying areas of muscle activation, but its sensitivity can be improved. In this study we compare the sensitivity of US-EMG alone with US-EMG after peripheral nerve stimulation (NC-US-EMG) to better identify active muscle regions.

METHODS

In this prospective study, 32 patients with severe TNLs were evaluated with standard EMG (ST-EMG), US-EMG, and NC-US-EMG at baseline (T0), after 2 to 3 months (T1), and after 5 to 6 months (T2).

RESULTS

NC-US-EMG was more sensitive in detecting MUPs compared with US-EMG and ST-EMG at T0 (19 patients vs 14 and 5 patients, respectively). In addition, both US-guided techniques were more sensitive than ST-EMG in detecting MUPs (ST-EMG vs US-EMG: P = .014; ST-EMG vs NC-US-EMG: P = .003). At T1, ST-EMG remained less sensitive NC-US-EMG (P = .019). No significant differences were observed among the three techniques at T2.

DISCUSSION

In the evaluation of severe TNLs, the combination of peripheral nerve stimulation and US increases the sensitivity of EMG for MUP detection at baseline and 2 to 3 months postinjury.

摘要

简介/目的：在创伤性神经损伤（TNL）中，运动单位电位（MUP）在早期损伤时可能难以检测。超声引导肌电图（US-EMG）可辅助识别肌肉激活区域，但可提高其敏感性。本研究比较了单独使用 US-EMG 与外周神经刺激后使用 US-EMG（NC-US-EMG）的敏感性，以更好地识别活跃的肌肉区域。

方法

在这项前瞻性研究中，32 例严重 TNL 患者在基线（T0）、伤后 2 至 3 个月（T1）和 5 至 6 个月（T2）时接受标准肌电图（ST-EMG）、US-EMG 和 NC-US-EMG 评估。

结果

与 US-EMG 和 ST-EMG 相比，NC-US-EMG 在 T0 时检测到 MUP 的敏感性更高（分别为 19 例、14 例和 5 例）。此外，两种 US 引导技术均比 ST-EMG 更敏感（ST-EMG 与 US-EMG：P=0.014；ST-EMG 与 NC-US-EMG：P=0.003）。在 T1 时，ST-EMG 仍比 NC-US-EMG 不敏感（P=0.019）。在 T2 时，三种技术之间未观察到显著差异。