高频超声诊断坐骨神经及其分支病变

High-frequency ultrasonography in the diagnosis of sciatic nerve and branches diseases

目的探讨高频超声在坐骨神经及其分支病变诊断的临床应用价值。方法对78例临床疑有坐骨神经或其分支病变的患者进行高频超声检查,将图像质量分为优劣两组。对图像质量优组进行超声诊断,并将超声检查结果与临床资料进行对照分析。结果 78例患者中,超声图像质量差者7例(8.97%),图像质量好、可做超声诊断者71例(91.03%)。此71例患者中,经临床最终确诊为坐骨神经或其分支病变57例,其中外伤或手术后神经损伤为39例,肿瘤性病变12例,慢性卡压3例,特发性神经炎1例,截肢术后断端神经瘤1例,遗传性运动神经元病累及坐骨神经及其分支1例。超声诊断坐骨神经分支及其病变敏感度、特异度和准确率分别为84.21%、100%和87.32%。结论高频超声对于诊断坐骨神经及其分支病变具有较大的临床应用价值,可作为常规的检查手段之一。

Objective To observe the value of high-frequency ultrasonography in diagnosing the sciatic nerve and its branches diseases. Methods Seventy-eight patients with suspected abnormalities of sciatic nerve or its branches underwent high-frequency ultrasonography. The sonograms were categorized as good or poor quality. The sonograms with good quality were diagnosed and compared with the final clinical data. Results In all patients, sonographic images of the sciatic nerve with good quality were obtained in 91.03% （71/78）. Among these 71 patients, 57 were proved with nerve diseases, including 39 with nerve injury, 12 with nerve tumor, 3 with nerve entrapment, 1 with idiopathic neuritis, 1 with amputation neuroma and 1 with hereditary motor neuron disease. The sensitivity, specificity and accuracy of ultrasonography in diagnosing sciatic nerve abnormalities was 84.21%, 100% and 87.32%, respectively. Conclusion High-frequency ultrasonography is useful in diagnosis of the sciatic nerve and its branches diseases and can become an important imaging modality for sciatic nerve.