高频超声检查对腕管综合征的诊断价值

Value of high-frequency ultrasound examination in diagnosis of carpal tunnel syndrome

目的探讨高频超声检查对腕管综合征(CTS)的诊断价值。方法对28例(47侧)临床诊断为CTS的患者,按照电生理分期诊断标准分为早、中、晚三期。应用高频超声检查测量三期患者正中神经内径、屈肌支持带厚度,桡尺关节、豌豆骨及钩骨钩平面正中神经截面积,并与20例(40侧)正常腕管超声结果进行对比研究。结果中、晚期CTS患者腕部各部位超声检查结果与对照组比较差异均有统计学意义,但早期CTS患者仅在豌豆骨平面正中经截面积与对照组比较差异有统计学意义[(0.12±0.03)cm2vs.(0.08±0.02)cm2,P<0.05]。结论高频超声检查是诊断CTS的一种新的可靠方法,尤其对中晚期CTS的临床诊断价值较大。

Objective To evaluate the value of high-frequency ultrasound examination in the diagnosis of carpal tunnel syndrome（CTS）.Methods Twenty-eight patients（47 sides） of clinically diagnosed CTS were divided into early stage,intermediate stage,and late stage according to the electrophysiological findings.High-frequency ultrasound examination was conducted in these patients and 20（40 sides） healthy volunteers.Inner diameter of median nerve,thickness of palmar retinaculum,and cross sectional area of the median nerve at radioulnar joint level,pisiform level,and hamate hook level were observed and measured.Data from the patient and control group were compared to determine the statistical significance.Results All measurement parameters showed significant differences between patients and controls in the intermediate and late stage CTS.However,for the early stage patients,only the cross sectional area at pisiform level was significantly wider than that of the healthy controls [（0.12±0.03） cm2 vs.（0.08±0.02） cm2,P 0.05].Conclusion High-frequency ultrasound examination is a new and reliable method for the diagnosis of CTS,especially for the intermediate and late stage patients.