超声剪切波弹性成像对腕管综合征的诊断价值及其影响因素分析  

Diagnostic value and influencing factors of shear wave elastography in the carpal tunnel syndrome

作　　者：杨聪聪 逄淑东 徐静 刘村[3] YANG Congcong;PANG Shudong;XU Jing;LIU Cun(Shandong Second Medical University,Weifang 261053,China;Department of Ultrasound,Shandong Provincial Third Hospital,Jinan 250031,China;Department of Ultrasound,Jinan Central Hospital,Jinan 250013,China)

机构地区：[1]山东第二医科大学,山东潍坊261053 [2]山东省立第三医院超声医学中心,山东济南250031 [3]山东省济南市中心医院超声科,山东济南250013

出　　处：《医学影像学杂志》2024年第8期119-123,共5页Journal of Medical Imaging

基　　金：山东省中医药科技计划项目(编号:2021M198)。

摘　　要：目的 探讨超声剪切波弹性成像(SWE)对腕管综合征(CTS)的诊断价值及其主要影响因素。方法 选取我院超声检查并经手术或肌电图佐证的CTS患者172例(共204腕)为CTS组,另选取同时期同年龄段78例健康体检者的左右侧(156腕)为对照组,使用SEW测量所有受试者的正中神经弹性,记录受试者的相关二维超声检查指标,并对其数据进行相关统计学分析。结果 1)两组患者在年龄、性别方面差异无统计学意义(P>0.05),但CTS组正中神经的厚度、扁平比、横截面积、血流信号及杨氏模量值较对照组明显增加,差异有统计学意义(P<0.05);2)豌豆骨平面正中神经弹性在诊断CTS的受试者工作特征(ROC)曲线显示,左侧曲线下面积(AUC)为0.908(95%CI 0.830~0.987),临界值为45.00Kpa时,超声检查诊断CTS的敏感度为100%,特异度为92.3%;右侧AUC为0.941(95%CI 0.877~1.000),临界值为44.48 Kpa时,超声诊断CTS的敏感度为100%,特异度为96.2%;3)正中神经弹性杨氏模量与年龄、性别、BMI无明显相关性(P>0.05),与厚度、扁平比、横截面积及血流评分呈显著正相关(P<0.05),其中正中神经横截面积是影响CTS组左侧正中神经弹性杨氏模量升高的独立影响因素,正中神经厚度、横截面积是影响CTS组右侧正中神经弹性杨氏模量升高的独立影响因素。结论 通过SWE对正中神经弹性值进行准确测值,可有助于CTS的诊断,且弹性值与厚度、扁平比、横截面积及血流评分均相关,其中厚度及横截面积是影响CTS患者正中神经弹性杨氏模量的独立影响因素。Objective To investigate the diagnostic value and main influencing factors of ultrasound shear wave elastography(SWE)in carpal tunnel syndrome(CTS).Methods A total of 172 patients(204 wrists)with CTS who were diagnosed by ultra-sound and supported by surgery or electromyography were selected as the CTS group,and 78 patients(156 wrists)of the same age group were selected as the control group.Results 1)The data showed that there was no significant difference in age and gender between the two groups(P<0.05),but the median nerve thickness,flattening ratio,cross-sectional area,blood flow signal and Young's modulus in the CTS group were significantly higher than those in the control group;2)The ROC curve of median nerve elasticity in the pea bone plane in the diagnosis of CTS showed that the area under the left curve was 0.908(95%confidence in-terval:0.830~0.987),and the cut-off value was 45.00 Kpa,the sensitivity and specificity of ultrasound for the diagnosis of CTS were 100%and 92.3%,respectively.When the area under the right curve was 0.941(95%confidence interval:0.877~1.000)and the cut-off value was 44.48Kpa,the sensitivity and specificity of ultrasound for the diagnosis of CTS were 100%and 96.2%;and 3)There was no significant correlation between median nerve elasticity Young's modulus and age,gender and BMI,but was significantly positively correlated with thickness,flattening ratio,cross-sectional area and blood flow signal,among which the median nerve cross-sectional area was an independent influencing factor for the increase of left median nerve elasticity in the CTS group,and the median nerve thickness and cross-sectional area were the independent influencing factors for the increase of right median nerve elasticity in the CTS group.Conclusion The accurate measurement of median nerve elasticity value by SWE can help the diagnosis of CTS,and the elasticity value is related to thickness,flattening ratio,cross-sectional area and blood flow sig-nal,among which thickness and cross-sectional area are independent inf

关 键 词：腕管综合征 剪切波弹性成像 超声检查 

分 类 号：R745.04[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]