高频超声和SWE定量参数与肘管综合征患者尺神经电生理相关性及诊断价值

Correlation and diagnostic value of high frequency ultrasound and SWE quantitative parameters with ulnar nerve electrophysiology in patients with cubital tunnel syndrome

目的探究高频超声和剪切波弹性成像(SWE)定量参数与肘管综合征(CTS)患者尺神经电生理相关性及对CTS的诊断价值。方法选取2021年12月—2022年12月期间新疆医科大学第二附属医院收治的49例CTS患者,纳入CTS组,选取同期体检健康的志愿者49例纳入对照组。所有研究对象均进行高频超声检查、SWE及尺神经电生理检查,采用Pearson法分析CTS患者高频超声参数[内上髁横截面积(CSA)、尺神经最大横径及周长]、SWE定量参数[弹性模量均值(EI)、剪切波速度(V)]与尺神经电生理检查结果[运动传导速度(MCV)、感觉传导速度(SCV)]的相关性,并采用ROC曲线分析高频超声检查、SWE定量参数对CTS的诊断价值。结果CTS组患者CSA、EI及V水平均高于对照组(P<0.05),2组患者尺神经最大横径、周长比较差异均无统计学意义(P>0.05);CTS组患者MCV及SCV水平均低于对照组(P<0.05)。Pearson相关性分析结果显示,CSA、EI及V与MCV、SCV均呈负相关关系(P<0.05)。ROC曲线分析结果显示,CSA、EI及V单独及联合诊断CTS的AUC(95%CI)分别为0.679(0.577~0.770)、0.718(0.618~0.804)、0.720(0.620~0.806)、0.893(0.815~0.947),三者联合诊断效能高于各项单独检测(Z=3.065、2.899、2.734,P<0.05)。结论CTS患者高频超声和SWE定量参数与尺神经电生理指标存在明显的相关性,其中CSA、EI及V均可用于CTS的诊断,三者联合对CTS具有较高的诊断价值。

Objective To explore the correlation of quantitative parameters of high frequency ultrasound and shear wave elastography(SWE)with ulnar nerve electrophysiology in patients with cubital tunnel syndrome(CTS)and the diagnostic value of CTS.Methods A total of 49 patients with CTS admitted to the Second Affiliated Hospital of Xinjiang Medical University from December 2021 to December 2022 were included in the CTS group.A total of 49 healthy volunteers were included in the control group.All patients underwent high-frequency ultrasonography,SWE and ulnar nerve electrophysiological examination.Pearson method was used to analyze the correlation between high-frequency ultrasound examination[medial epicondylar cross-sectional area(CSA),maximum transverse diameter and circumference of ulnar nerve],SWE quantitative parameters[mean elastic modulus(EI),shear wave velocity(V)]with ulnar nerve electrophysiological examination results[motor conduction velocity(MCV)and sensory conduction velocity(SCV)]in CTS patients.ROC curve was used to analyze the diagnostic value of high-frequency ultrasonography and SWE quantitative parameters for CTS.Results The levels of CSA,EI and V in CTS group were significantly higher than those in control group(P<0.05),and there was no significant difference in the maximum transverse diameter and circumference of ulnar nerve between two groups(P>0.05).The levels of MCV and SCV in CTS group were lower than those in control group(P<0.05).The results of Pearson correlation analysis showed that CSA,EI and V were negatively correlated with MCV and SCV(P<0.05).ROC analysis results showed that the AUC(95%CI)were 0.679(0.577-0.770),0.718(0.618-0.804),and 0.720(0.620-0.806)for CSA,EI and V in the diagnosis of CTS alone,respectively,and the value was 0.893(0.815-0.947)when combined.The diagnostic efficiency of the three combined tests was higher than that of each single test(Z=3.065,2.899,2.734,P<0.05).Conclusion In patients with high CTS,high-frequency ultrasound and SWE quantitative parameters are significantly correlated with the ulnar nerve electrophysiological indexes,among which CSA,EI and V can be used in the diagnosis of CTS,and the combination of the three has high diagnostic value.