高频超声诊断肢体外周神经病变的价值

Diagnosing Limb's Peripheal Nerve Diseases with High-Frequency Ultrasound

目的:探讨高频超声在肢体外周神经病变诊断中的应用价值。材料和方法:2004-01～2006-05对30例肢体外周神经正常者和32例肢体外周神经病变患者(肢体外周神经损伤25例,肢体外周神经纤维瘤3例,神经鞘膜瘤4例)行肢体外周神经高频超声检查。结果:正常肢体外周神经纵切面超声表现为条索状管形结构,其表面为连续带状高回声,内部为多条平行线性回声;横切面为圆形、椭圆形,内有散在点状回声结构。肢体外周神经损伤诊断正确23例,误诊2例。其中神经完全或部分断裂者声像图表现为神经外膜的带状高回声及内部平行线性回声连续性完全中断或部分中断;神经炎性肿胀粘连声像图表现为神经增粗,神经外膜的带状高回声模糊,内部平行线性回声不清晰。肢体外周神经源性肿瘤诊断正确7例,误诊1例。其声像图表现为实性低回声肿物,呈圆形或椭圆形,有完整包膜,可见肿物与神经纤维相连,并观察到神经纤维瘤的中心有神经经过,而神经鞘膜瘤无此征象。结论:高频超声对外周神经损伤和肿瘤有较好的诊断价值,对临床治疗和选择手术方案有重要指导意义。

Purpose： In the current study, the clinical value of high-frequancy ultrasound in diagnosing limb＇s peripheal nerve diseases was assessed. Materials Methods： From Jan. 2004 to May 2006, 32 cases of peripheral nerve disease underwent high frequency ultrasound imaging. The sonographic characteristics of the cases, including 25 nerve lesions, 3 neurofibroma and 4 neurinoma were compared with that of 30 controls. Results： High-frequency ultrasound could clearly display the normal peripheal nerves structures. Ultrasonic images at longitu-dinal section showed tubal stripe structure with inner parallel linear shaped echo, and circular or elliptical structure with inner scattering dots at transverse section. Ultrasound correctly diagnosed 23 of 25 peripheal nerve lesions, displaying interrupted or deficient inner parallel echo. The correct diagnosis of limb＇s peripheral nerve tumors was obtained in 6/7 cases, displaying circular or elliptical neoplasm of low echo with clear membrane. The nerve connect and pass through tumor center was diagnostic in neurofibroma that was different from neurinoma. Condusion： High-frequency ultrasound is of value in the diagnosis of peripheral nerve lesion and tumor.