神经内外囊肿致周围神经卡压的超声诊断  

Diagnosis of Peripheral Nerve Entrapment Induced by Cysts Inside and Adhered to Nerves Using Ultrasonography

作　　者：陈定章[1] 朱永胜[1] 郑敏娟[1] 张蕴楚[2] 赵睿 罗璐[1] 周晓东[1] 

机构地区：[1]解放军第四军医大学西京医院超声科,西安市710032 [2]武警北京总队三院超声科 [3]西京医院手外科

出　　处：《中国超声医学杂志》2013年第9期822-824,共3页Chinese Journal of Ultrasound in Medicine

基　　金：陕西省社发功关项目(No.2013k12-20-01);第四军医大学西京医院临床高新技术项目(No.XJGX12C14)

摘　　要：目的探讨超声在诊断神经内、外囊肿致周围神经损伤的价值。方法用高频超声检查和诊断8例肘部尺神经损伤伴囊肿和9例腓总神经损伤伴囊肿,观察其神经内、外囊肿致周围神经损伤声像图表现。结果 8例肘部尺神经损伤伴囊肿和9例腓总神经损伤伴囊肿,其中12例超声显示神经增粗水肿,内部束状回声消失或不连续,点线回声不清楚,神经周围局部呈无回声与周围软组织粘连;5例超声显示神经增粗水肿,外膜回声强,内部束状回声消失,呈瘤样低回声与神经相连续,其内有血流改变,部分束间有少量积液,神经周围无明显积液。12例术中探查所见与超声检查结果相吻合,5例不完全一致。结论肘关节囊液和上胫腓关节液流注可形成肘部尺神经和腓总神经内、外囊肿,声像图表现均有不同,神经内囊肿较神经外囊肿致神经损伤较重。结合不同声像图特征进行鉴别,以便尽早发现与诊治有非常重要的意义。Objective The goal of this study was to investigate the clinical applicability of ultrasonography （US） in the diagnosis of peripheral nerve entrapment induced by cysts inside or adhered to the nerves. Methods A high-resolution uhrasonographic tests were performed in 8 patients with ulnar nerve lesions and in 9 patients common peroneal nerve lesions, all accompanied with cysts aroud the nerves. The ultrasonographic findings of the patients were evalua- ted. Results In 12 patients, there appeared nerve enlargement and edema, with disappearance or discontinuation of normal fascicle-like inner echoes and there appeared echo-free cystic areas adhered to the nerves. In the other 5 patients, there were no echo-free cystic areas or fluid detected around nerves, only appeared hypoechoic tumor-like nerve enlargement and edema, with alteraions of blood flow signals inside, a small amount of fluid assembled between fascicles and disappearance or discontinuation of normal fascicle like inner echoes. Intraoperative explorations revealed there were cysts inside or adhered to ulnar or common peroneal nerves. Therefore, preoperative diagnoses by ultrasonography were not exactly consistant with intraoperative explorations in 5 cases. Conclusions Discharge of fluid in side elbow or superior tihiofibular joint eapssule can assemble inside or around ulnar or common peroneal nerves and form cysts inside or adhered to nerves. Clinical manifestations are more severe in patients with cysts inside nerves than in patients with cysts adhered to nerves. The ultrasonographie characteristics of these two types of cysts are somehow different from each. Hence knowledge and experiences should he accumalated to provide a convenient and accurate ima ging modality in early and quick diagnosis of cystic lesions inside or adhered to peripheral nerves by uhrasonography.

关 键 词：周围神经 囊肿 损伤 超声诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]