剪切波弹性成像评估慢性血液透析患者腕管综合征的价值  

Evaluation of Median Nerve in Chronic Hemodialysis Patients with Carpal Tunnel Syndrome by Shear Wave Elastography

作　　者：郑琪 焦玉婷 周学敏 崔广和[1] 刘菲菲[1] Zheng Qi;Jiao Yuting;Zhou Xuemin;Cui Guanghe;Liu Feifei(Department of Ultrosound Medicine,Binzhou Medical University Hospital,Binzhou,Shandong 256603,China)

机构地区：[1]滨州医学院附属医院超声医学科,山东省滨州市256603

出　　处：《中国超声医学杂志》2024年第7期809-813,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 评估超声剪切波弹性成像(SWE)诊断慢性血液透析(HD)患者腕管综合征(CTS)的价值。方法 共纳入20例无CTS的HD患者(HD组)、23例有CTS的HD患者(HD-CTS组)和21例健康体检者(对照组),用超声和SWE分别测量正中神经的横截面积(CSA)和剪切波速度(SWV)。结果 与HD组和对照组相比,HD-CTS组的正中神经CSA和SWV显著增大(P<0.001)。HD组的SWV显著高于对照组(P<0.001),而CSA两组间比较无显著差异。SWV的曲线下面积(0.893)明显大于CSA(0.765),两者比较差异有统计学意义(Z=1.997,P=0.046)。SWE诊断CTS的最佳截断值为3.95 m/s,灵敏度为78.95%,特异度为87.50%。结论 伴有CTS的HD患者的正中神经硬度明显增大。在HD患者的CTS诊断中,基于SWE的正中神经硬度测量优于CSA。CSA和SWV均不能区分轻度与中度CTS、中度与重度CTS。Objective To evaluate the value of shear wave elastography(SWE) in diagnosis of carpal tunnel syndrome(CTS) in chronic hemodialysis(HD) patients.Methods A total of 20 HD patients without CTS(HD group),23 HD patients with CTS(HD-CTS group) and 21 healthy individuals(control group) were enrolled in this study.Ultrasonography and SWE were used to evaluate the cross-sectional area(CSA) and shear wave velocity(SWV) of the median nerve separately.Results The HD-CTS group exhibited a significantly larger CSA and higher SWV,when compared to the HD and control groups(P<0.001).The SWV was significantly greater in the HD group than that in the control group(P<0.001),while CSA was not significantly different between the groups.The area under the curve(AUC) of SWV(0.893) was significantly greater than that of CSA(0.765),the difference were statistically significant(Z=1.997,P=0.046).The optimal cut-off value of SWE for CTS diagnosis was 3.95 m/s,with a good sensitivity(78.95%) and specificity(87.50%).Conclusions Median nerve stiffness is significantly higher in HD patients with CTS.The SWE-based stiffness measurement of the median nerve was superior to CSA in the CTS diagnosis among HD patients.Both CSA and SWV could not differentiate between mild to moderate CTS and moderate to severe CTS.

关 键 词：腕管综合征 剪切波弹性成像 慢性血液透析 超声 

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] R692.5[医药卫生—临床医学]