超声诊断外周神经病变的临床价值

Diagnosis of peripheral nerve lesions by high frequency ultrasonography

目的探讨高频超声在外周神经病变和损伤中的诊断价值。方法应用高频超声检查15例正常查体肢体外周神经、12例外周神经损伤及6例神经肿瘤,术前超声检查与术中探查结果作比较分析。结果正常神经纵切面声像图为多条线性的平行较强回声;横切面为圆形中等回声结构,中心为点状强回声。2例外周神经完全离断,显示连续性中断,近端形成神经瘤;7例外周神经部分损伤,显示连续性部分中断;3例卡压性损伤,神经水肿增粗,内部呈束状低回声不清晰。6例神经肿瘤与神经相连续。结论高频超声可作为外周神经病变和损伤首选的检查方法,值得临床推广应用。

Objective To evaluate the application of high frequency ultrasonography in diagnosis of peripheral nerve lesions and trauma. Methods Fifteen healthy volunteers, 12 patients with peripheral nerve trauma and 6 patients with peripheral nerve neoplasm were examined before operation with high frequency ultrasonography and compared with the outcome of operation. Results The peripheral nerve appeared as tubular echogenic structure with parallel linear echoes on long axis views, and as a round echogenic structure with punctiform echoes on transverse views. Nerves were damaged completely in 2 cases which were depicted with interrupture of nerve continuity and proximal traumatic neuroma, and nerves were damaged partly with partial interrupture in 7 cases. Nerve compressions with low inner echo and intensive outer layer echo were seen in 3 patients. Peripheral nerve neoplasm were visualized as masses connected with nerves in 6 patients. Conclusions High frequency ultrasonography should be of choice in noninvasive diagnosis of peripheral nerve lesions and is worth to be used widely in clinic practice.