梨状肌综合征的超声诊断价值

The value of ultrasonography in the diagnosis of piriformis syndrome

目的探讨超声对梨状肌综合征的诊断价值。方法对38例临床诊断为单侧梨状肌综合征的患者和40例健康志愿者行超声检查，观察梨状肌和坐骨神经的形态结构及内部回声，测量并比较健康志愿者及梨状肌综合征患者两侧梨状肌及坐骨神经的厚度。结果健康志愿者梨状肌及坐骨神经均未见异常改变，两侧梨状肌及坐骨神经厚度差异无统计学意义（P〉O．05）。梨状肌综合征患者患侧梨状肌及坐骨神经的形态结构及内部回声均有改变，且患侧梨状肌的厚度明显大于健侧[（25．74±3．12）mm对（22．48±2．60）mm，P〈0．053，用两侧梨状肌厚度的差值诊断梨状肌综合征的ROC曲线下面积为0．896，最优诊断点为2．15mm。梨状肌综合征患者两侧坐骨神经厚度差异无统计学意义（P〉0．05）。结论超声检查能清晰显示梨状肌及坐骨神经，其超声改变及两侧梨状肌厚度的差值有助于诊断梨状肌综合征，可为临床提供更多的诊断信息。

Objective To discuss the diagnostic value of ultrasonography in piriformis syndrome. Methods Ultrasonography was performed in thirty-eight patients with unilateral piriformis syndrome and forty healthy volunteers. The morphological structures and the internal echoes of their bilateral piriformises and sciatic nerves were observed and their thicknesses were measured. These parameters of the patients and voluteers were recorded and compared. Results The ultrasonographic images of piriformis and sciatic nerve of the healthy voluteers showed no abnormal change. The thickness difference of their bilateral piriformises and sciatic nerves had no statistical significance （P 〉 0.05）. The ultrasonography image of the morphological structure and the internal echo of the sick side piriformis and sciatic nerve of the patients with piriformis syndrome showed a change, that the sick side piriformis was significantly thicker than the healthy sidepiriformis [（25.74± 3.12）mm vs （22.48 ± 2.60）mm, P 〈0.05]. The area under the operator characteristic curve （AUC） for the thickness difference of bilateral piriformises in diagnosing piriformis syndrome was 0. 896, with the optimal cut-off value of 2.15 ram. However, the thickness difference of their bilateral sciatic nerves had no statistical significance （ P 〉0.05）. Conclusions Ultrasonography can show piriformis and sciatic nerve clearly. The ultrasonographic images and the thickness difference of the bilateral piriformises is helpful to diagnose piriformis syndrome, and can provide more informations for clinic.