摘要
目的探讨实时剪切波弹性成像(SWE)在不同程度腕管综合征中的应用价值。方法选择腕管综合征患者84例,共100根正中神经,其中单侧病变68例,双侧病变16例。依据神经电生理检查提示正中神经损伤严重程度将100根正中神经分为轻度(n=42)、中度(n=34)和重度(n=24)3组。选择健康体检者(对照组)21例,共42根正中神经(n=42)。对各组均行正中神经的常规二维超声及SWE检查,分别检查正中神经的腕部豌豆骨水平横截面积(CSA_W)、弹性模量均值(W_(Emean))、腕横纹以上5cm处弹性模量均值(F_(Emean))及同一感兴趣区(ROI)内正中神经与指浅屈肌的弹性模量均值比(F_(Ratio)),比较轻度、中度、重度3组与对照组之间的差异,并绘制受试者工作特性(ROC)曲线。结果轻度组正中神经的W_(Emean)值及重度组的CSA_W值和中度、重度2组W_(Emean)、F_(Emean)、F_(Ratio)值均明显高于对照组(均P<0.05)。中度、重度2组正中神经的W_(Emean)、F_(Emean)值及中度组F_(Ratio)值和重度CSA_W值均明显高于轻度组(均P<0.05)。重度组正中神经的CSA_W值明显高于中度组(P<0.05)。CSA_WAUC与W_(Emean)、F_(Ratio)、F_(Emean)比较差异有统计学意义(P<0.05),CSA_W诊断效能与W_(Emean)、F_(Ratio)、F_(Emean)比较差异有统计学意义(P<0.05)。结论 SWE能够提供正中神经平均弹性模量值,定量正中神经的硬度,在不同程度腕管综合征的诊断中具有重要的价值。
引文
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