高频超声诊断旋前圆肌综合征的应用价值  

Value of High-Frequency Ultrasound in the Diagnosis of Pronator Teres Syndrome

作　　者：胡闽 陈仕宇 杨晓龙 林天放 王接丰 臧正华 HU Min;CHEN Shiyu;YANG Xiaolong;LIN Tianfang;WANG Jiefeng;ZANG Zhenghua(Department of Ultrasonography,Yueqing Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325600,China;Department of Pain,Yueqing Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325600,China)

机构地区：[1]温州医科大学附属乐清医院超声医学科,浙江温州325600 [2]温州医科大学附属乐清医院疼痛科,浙江温州325600

出　　处：《中国医学科学院学报》2023年第3期436-439,共4页Acta Academiae Medicinae Sinicae

基　　金：温州市医药卫生科研项目(2021042);浙江省卫生健康科技计划(2022KY1213)。

摘　　要：目的 探讨高频超声诊断旋前圆肌综合征(PTS)的临床应用价值。方法 采用高频超声对30例PTS患者及30名健康对照者旋前圆肌水平正中神经进行观察,测量正中神经长径(LA)、短径(SA)和横截面积(CSA)。以手术结果作为参照,绘制正中神经超声测量结果受试者工作特性曲线,并计算曲线下面积(AUC),比较各测量指标对PTS诊断的性能。结果 与对照组比较,PTS组正中神经LA[(5.02±0.50)mm比(3.89±0.41)mm;t=4.38,P=0.013]、SA[(2.55±0.46)mm比(1.70±0.41)mm;t=5.19,P=0.009]和CSA[(11.13±3.72)mm^(2)比(6.88±2.68)mm^(2);t=8.42,P=0.008]明显增大。CSA、SA和LA诊断PTS的AUC分别为94.3%(95%CI=0.912~0.972,Z=3.586,P=0.001)、77.7%(95%CI=0.734~0.815,Z=2.855,P=0.006)、78.8%(95%CI=0.752~0.821,Z=3.091,P=0.004),以8.63 mm^(2)为截断值,CSA诊断PTS敏感度为93.3%,特异度为90.0%。结论 高频超声是诊断PTS的有效方法,其中正中神经CSA具有较高的诊断价值。Objective To investigate the clinical value of high-frequency ultrasound in the diagnosis of pronator teres syndrome(PTS).Methods The high-frequency ultrasound was employed to examine and measure the median nerve of the pronator teres muscle in 30 patients with PTS and 30 healthy volunteers(control group).The long-axis diameter(LA),short-axis diameter(SA)and cross-sectional area(CSA)of the median nerve were measured.The receiver operating characteristic curve of the median nerve ultrasonic measurement results was established,and the area under the curve(AUC)was calculated.The diagnostic efficiency of each index for PTS was compared with the surgical results as a reference.Results The PTS group showed larger LA[(5.02±0.50)mm vs.(3.89±0.41)mm;t=4.38,P=0.013],SA[(2.55±0.46)mm vs.(1.70±0.41)mm;t=5.19,P=0.009],and CSA[(11.13±3.72)mm^(2) vs.(6.88±2.68)mm^(2);t=8.42,P=0.008]of the median nerve than the control group.The AUC of CSA,SA,and LA was 94.3%(95%CI=0.912-0.972,Z=3.586,P=0.001),77.7%(95%CI=0.734-0.815,Z=2.855,P=0.006),and 78.8%(95%CI=0.752-0.821,Z=3.091,P=0.004),respectively.With 8.63 mm^(2) as the cutoff value,the sensitivity and specificity of CSA in diagnosing PTS were 93.3%and 90.0%,respectively.Conclusion High-frequency ultrasound is a practical method for diagnosing PTS,and the CSA of median nerve has a high diagnostic value.

关 键 词：高频超声 旋前圆肌综合征 正中神经卡压 

分 类 号：R445.1[医药卫生—影像医学与核医学] R741.049[医药卫生—诊断学]