超高频剪切波弹性超声成像检测正中神经改变对腕管综合征的诊断价值*

Diagnostic value of ultra-high frequency shear wave elastography in the carpal tunnel syndrome*

摘要:

目的?探讨超高频剪切波弹性超声成像检测正中神经改变对腕管综合征（CTS）的诊断价值。方法?选取2017年3月—2019年12月宁波大学医学院附属医院收治的经临床和神经电生理检查诊断为CTS的患者108例作为CTS组，另取同期该院健康体检者30例作为对照组。对两组受试者行超高频剪切波弹性超声成像检查，比较两组受试者各参数的差异，绘制受试者工作特征曲线，分析各参数对CST的诊断效能。 结果?两组二维超声结果显示，CTS组正中神经DW、CSAW值高于对照组（P?<0.05）。超高频剪切波弹性超声成像结果显示，CTS组豌豆骨水平正中神经的弹性模量均值（WEmean）、前臂区距离腕横纹上5cm处正中神经弹性的弹性模量均值（FEmean）及该平面同一目标区域内正中神经与指浅屈肌的弹性模量均值比（FRatio）高于对照组（P?<0.05）。ROC曲线结果显示，WEmean、FEmean、FRatio诊断CTS的曲线下面积（AUC）分别为0.830、0.768和0.752，敏感性分别为83.17%（95% CI：0.798，0.907）、79.32%（95% CI：0.712，0.856）、72.38%（95% CI：0.705，0.822），特异性分别为78.33%（95% CI：0.831，0.916）、82.15%（95% CI：0.792，0.879）、67.29%（95% CI：0.710，0.813）。结论?超高频剪切波弹性超声成像可准确反映正中神经硬度，从而为CTS临床诊断提供一种无创、简便的方式，具有良好的临床应用价值。

Abstract:

Objective To explore the diagnostic value of detecting the change of median nerve by ultra-high frequency shear wave elastography in carpal tunnel syndrome (CTS). Methods From March 2017 to December 2019, a total of 108 patients with CTS diagnosed by clinical and neuroelectrophysiological examination were selected as CTS group, and 30 healthy subjects in our hospital were selected as control group. Two groups of subjects were examined by shear wave elastography, and the differences of parameters between the two groups were compared. Results Two dimensional ultrasound showed that DW and CSAW of median nerve in CTS group were significantly higher than those in control group (P?