剪切波弹性成像在非典型腕管综合征诊断中的临床应用价值  

The clinical application value of shear wave elastography in diagnosing atypical carpal tunnel syndrome

作　　者：邝献宝 曾灵峰[1] 周艳芳[1] 张彤[1] KUANG Xian-bao;ZENG Ling-feng;ZHOU Yan-fang;ZHANG Tong(Department of Ultrasound Medicine,the First People’s Hospital of Chenzhou,Chenzhou Hunan 423000,China)

机构地区：[1]郴州市第一人民医院超声医学科,湖南郴州423000

出　　处：《中国临床医学影像杂志》2025年第4期288-292,共5页Journal of China Clinic Medical Imaging

基　　金：湖南省自然科学基金项目(编号:2023JJ50385);湖南省卫生健康委科研课题项目(编号:202209022899);郴州市第一人民医院科研项目(编号N2021-13)。

摘　　要：目的:评估剪切波弹性成像(SWE)在诊断非典型腕管综合征(CTS)中的临床应用价值。方法:选取我院CTS患者125例,根据症状将其分为典型CTS组(52例)与非典型CTS组(73例),另选取同期健康对照组96例。所有受试者均接受常规超声及SWE检查,以肌电图作为诊断“金标准”,本研究比较了三组在正中神经横截面积(CSA)、腕管入口处和旋前方肌下缘处的正中神经硬度值(YM1、YM2)、硬度比(YMratio)以及拇短展肌硬度值(YM3)上的差异。通过绘制受试者工作特征(ROC)曲线,分析及比较单项及联合指标在非典型CTS诊断中的效能。结果:非典型CTS组CSA、YM1和YMratio显著高于对照组(P<0.05);典型CTS组YM1及YMratio显著高于非典型CTS组(P<0.01);而典型CTS组与非典型CTS组CSA差异不显著(P>0.05);YM2、YM3在三组间差异不显著(P>0.05)。ROC曲线显示,CSA、YM1、YMratio及CSA联合YM1诊断非典型CTS的AUC分别为0.702、0.804、0.689、0.847,其中CSA联合YM1的AUC最高,敏感度、特异度分别为78.72%、85.45%。结论:SWE技术可定量反映不同类型CTS正中神经硬度变化,可作为诊断非典型CTS的有效辅助检查。Objective:To evaluate the clinical application value of shear wave elastography(SWE)in diagnosing atypical carpal tunnel syndrome(CTS).Methods:We selected 125 patients diagnosed with CTS at our hospital,dividing them into typical CTS group(52 cases)and atypical CTS group(73 cases)based on symptoms.Additionally,96 healthy controls were selected during the same period.All subjects underwent routine ultrasound and SWE examinations,with electromyography used as the diagnostic gold standard.We compared differences among the three groups in terms of cross-sectional area(CSA)of the median nerve,Young’s modulus(YM1,YM2)at the carpal tunnel inlet and proximal edge of the flexor retinaculum,stiffness ratio(YMratio),and Young’s modulus of the abductor pollicis brevis muscle(YM3).Receiver operating characteristic(ROC)curves were plotted to analyze and compare the performance of individual and combined indicators in diagnosing atypical CTS.Results:CSA,YM1,and YMratio in the atypical CTS group were significantly higher than those in the control group(P<0.05).YM1 and YMratio in the typical CTS group were significantly higher than those in the atypical CTS group(P<0.01),while CSA differences between the typical and atypical CTS groups were not significant(P>0.05).YM2 and YM3 did not differ significantly among the three groups(P>0.05).ROC curves showed that the AUCs for diagnosing atypical CTS with CSA,YM1,YMratio,and CSA combined with YM1 were 0.702,0.804,0.689,and 0.847,respectively,with CSA combined with YM1 showing the highest AUC,and sensitivity and specificity of 78.72%and 85.45%,respectively.Conclusion:SWE technology can quantitatively reflect changes in median nerve stiffness in different types of CTS and serves as an effective adjunctive examination for diagnosing atypical CTS.

关 键 词：腕管综合征 超声检查 

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