高频超声结合灰度技术诊断腕管综合征的可行性研究

The application of grayscale technique combined with high-resolution ultrasound in the diagnosis of carpal tunnel syndrome

目的探讨运用高频超声灰度技术诊断腕管综合征的可行性,并比较其与测量正中神经截面积法诊断腕管综合征的应用价值。方法对经电生理及临床症状确诊的35例腕管综合征患者的59侧患手和30例(60侧)无腕管综合征健康志愿者行腕管处高频超声检测,测量该处正中神经截面积(area of media nerve,MNA)和灰度(grayscale),结果行组间对比分析,由受试者工作特性曲线(receiver operating characteristic curve,ROC)评价灰度指标和截面积指标诊断腕管综合征的准确性。结果腕管综合征患者的豌豆骨水平正中神经灰度和截面积在对照组和观察组中均有显著性差异,灰度诊断腕管综合征的敏感性和特异性高于截面积。结论高频超声测量腕管处正中神经灰度是诊断腕管综合征的可靠方法。

Objective To investigate carpal tunnel syndrome(CTS)with high resolution ultrasound with grayscale technique and to compare the diagnosis value of area of median nerve(MNA)with grayscale in patients with clinically and nerve conduction study(NCS)defined CTS.Methods In 35 CTS patients(59 hands)and in 30 healthy controls(60 hands),MNA and grayscale of median nerve at carpal tunnel were studied with high-resolution ultrasound.Data were compared to determine the statistical significant.The accuracy of criteria for MNA and grayscale of carpal tunnel syndrome was evaluated using receiver-operating characteristic curve(ROC)analysis.Results MNA was significantly higher in the CTS patients than in controls,while grayscale was significantly lower in the CTS patients than in controls.A cut off value of<74.5 at the value of pisiform bone provided a sensitivity of 98%and a specificity of 92%,which was higher than MNA.Conclusion Sonographic measurement of grayscale of median nerve at carpal tunnel level is useful and dependent for the diagnosis of carpal tunnel syndrome.