微血流成像联合剪切波弹性成像对腕管综合征的诊断价值  

Value of Superb Microvascular Imaging Combined with Shear Wave Elastography in Diagnosing Carpal Tunnel Syndrome

作　　者：郭文池 彭梅[1] 方明娣[1] 伍婷婷[1] Guo Wenchi;Peng Mei;Fang Mingdi;Wu Tingting(Department of Ultrasound,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院超声科,合肥市230601

出　　处：《中国超声医学杂志》2022年第11期1290-1293,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨微血流成像(SMI)联合剪切波弹性成像(SWE)对腕管综合征(CTS)的诊断价值。方法 对27例(38腕)CTS患者和29例(39腕)健康志愿者分别利用SWE和SMI技术测量豌豆骨与钩骨钩水平正中神经的剪切波速度(SWV)、能量多普勒(PDI)和SMI的血流信号值,并绘制受试者工作特征(ROC)曲线,分析SWE和SMI单独与联合诊断CTS的效能。结果 对照组、CTS组SMI血流信号值分别为0.76±0.30、1.43±0.69,高于两组PDI的0.46±0.26、0.78±0.45,P<0.01。CTS组和对照组剪切波速度分别为(7.87±0.93)m/s、(6.52±0.87)m/s,两组比较差异具有统计学意义(P<0.01)。SMI和SWE联合诊断的曲线下面积(AUC)、灵敏度及特异度(0.933、84.2%、89.7%)均高于两者单独诊断(0.809、71.1%、84.6%;0.874、78.9%、79.5%),P<0.01。结论 两组人群中SMI较PDI检测血流更灵敏,且CTS组血流信号显示更丰富。CTS组剪切波速度高于对照组。SWE及SMI在CTS诊断中具有一定的应用价值,两者结合可以提高诊断的准确度。Objective To investigate the diagnostic value of superb microvascular imaging(SMI) combined with shear wave elastography(SWE) in carpal tunnel syndrome(CTS). Methods The shear wave velocity(SWV), power Doppler(PDI) and SMI blood flow signals of median nerve at the level of pisiform bone and hook of hamate bone were measured by SWE and SMI in 27 patients(38 wrists) with CTS and 29 healthy volunteers(39 wrists), respectively. The receiveroperating characteristic(ROC) curve was drawn to analyze the efficacy of SWE with SMI in the diagnosis of CTS alone and jointly. Results The blood flow signal values of SMI in control and CTS group were 0.76±0.30 and 1.43±0.69, respectively, higher than those of PDI in two groups 0.46±0.26 and 0.78±0.45, P<0.01. The SWV of the CTS group and the control group were(7.87±0.93)m/s and(6.52±0.87)m/s, respectively. There was a significant difference between the two groups, P<0.01. The area under the curve(AUC), sensitivity and specificity of SMI and SWE combined diagnosis(0.933,84.2%,89.7%) were higher than those of the single diagnosis(0.809, 71.1%, 84.6%),(0.874, 78.9%, 79.5%), P<0.01. Conclusions SMI is more sensitive than PDI in detecting blood flow in both groups, and the CTS group is more abundant. The SWV in CTS group are higher than those in control group. SWE and SMI have certain application value in the diagnosis of CTS, and the combination of them can improve the diagnostic accuracy.

关 键 词：微血流成像 剪切波弹性成像 腕管综合征 正中神经 

分 类 号：R445.1[医药卫生—影像医学与核医学] R688[医药卫生—诊断学]