神经电生理联合MRI检查在诊断肘管综合征中的应用
发布时间：2018-11-13 18:29
【摘要】：目的 探讨神经电生理联合MRI检查在诊断肘管综合征（CuTS）中的应用价值。 方法 对23例肘管综合征病人的患肘（30肘）和15例正常对照者的肘部（15肘）进行神经电生理和MRI检查。测量肘段尺神经运动传导速度（MCV），测量肘段尺神经卡压点近端肿胀最明显处及卡压点处尺神经横切面积（CSA1,CSA2）和尺神经相对信号强度（RSI1, RSI2），计算这两处的CSA比值（CSA1/CSA2）和RSI比值（RSI1/RSI2），即得CSAR、RSIR。将不同层面、分组的尺神经MRI参数进行独立样本t检验。将肘段MCV分别与CSA1、RSI1、CSAR、RSIR进行相关性分析。以临床及电生理诊断作为参考标准，，将MRI参数进行受试者工作特征(ROC)曲线分析。 结果 病例组CSA1、RSI1较CSA2、RSI2显著增大（P0.05）。病例组的CSA1、RSI1、CSAR、RSIR皆较对照组显著增大（P0.05）。病例组MCV与CSA1呈负相关（r=-0.62）、与CSAR呈负相关（r=-0.53），MCV与RSI1、RSIR无相关性。CSAR的ROC曲线下面积最大0.94（95%CI，0.83-1），最佳截断值为1.83，诊断肘管综合征的敏感性为93.3%，特异性为80%。 结论 神经电生理联合MRI检查能够提高肘管综合征的定位诊断准确率，MRI各参数中尺神经CSAR的增加具有最佳诊断准确性。
[Abstract]:Objective to evaluate the value of neuroelectrophysiology combined with MRI in the diagnosis of cubital tunnel syndrome (CuTS). Methods the elbows of 23 patients with cubital tunnel syndrome (30 cubits) and 15 normal controls (15 elbows) were examined by neuroelectrophysiology and MRI. The motor conduction velocity of ulnar nerve of elbow segment was measured by (MCV),. The area of ulnar nerve transverse section (CSA1,CSA2) and the relative signal intensity of ulnar nerve (RSI1, RSI2) were measured at the proximal swelling point of ulnar nerve compression point and the compression point of ulnar nerve. Calculate the CSA ratio (CSA1/CSA2) and the RSI ratio (RSI1/RSI2) at these two places, and get the CSAR,RSIR. The MRI parameters of ulnar nerve in different layers were tested by independent sample t-test. The correlation between elbow MCV and CSA1,RSI1,CSAR,RSIR was analyzed. With clinical and electrophysiological diagnosis as the reference standard, the MRI parameters were analyzed by (ROC) curve. Results the CSA1,RSI1 in the case group was significantly higher than that in the CSA2,RSI2 group (P 0.05). The CSA1,RSI1,CSAR,RSIR in the case group was significantly higher than that in the control group (P0.05). There was a negative correlation between MCV and CSA1 (r-0.62) and CSAR (r-0.53), MCV and RSI1,RSIR). The maximum area under ROC curve of CSAR was 0.94 (95CI0.83-1), and the best truncation value was 1.83. The sensitivity of diagnosis of cubital tunnel syndrome was 93. 3 and the specificity was 80. Conclusion the accuracy of localization and diagnosis of cubital tunnel syndrome can be improved by the combination of nerve electrophysiology and MRI. The increase of ulnar nerve CSAR in all parameters of MRI has the best diagnostic accuracy.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R688
本文编号：2330067
[Abstract]:Objective to evaluate the value of neuroelectrophysiology combined with MRI in the diagnosis of cubital tunnel syndrome (CuTS). Methods the elbows of 23 patients with cubital tunnel syndrome (30 cubits) and 15 normal controls (15 elbows) were examined by neuroelectrophysiology and MRI. The motor conduction velocity of ulnar nerve of elbow segment was measured by (MCV),. The area of ulnar nerve transverse section (CSA1,CSA2) and the relative signal intensity of ulnar nerve (RSI1, RSI2) were measured at the proximal swelling point of ulnar nerve compression point and the compression point of ulnar nerve. Calculate the CSA ratio (CSA1/CSA2) and the RSI ratio (RSI1/RSI2) at these two places, and get the CSAR,RSIR. The MRI parameters of ulnar nerve in different layers were tested by independent sample t-test. The correlation between elbow MCV and CSA1,RSI1,CSAR,RSIR was analyzed. With clinical and electrophysiological diagnosis as the reference standard, the MRI parameters were analyzed by (ROC) curve. Results the CSA1,RSI1 in the case group was significantly higher than that in the CSA2,RSI2 group (P 0.05). The CSA1,RSI1,CSAR,RSIR in the case group was significantly higher than that in the control group (P0.05). There was a negative correlation between MCV and CSA1 (r-0.62) and CSAR (r-0.53), MCV and RSI1,RSIR). The maximum area under ROC curve of CSAR was 0.94 (95CI0.83-1), and the best truncation value was 1.83. The sensitivity of diagnosis of cubital tunnel syndrome was 93. 3 and the specificity was 80. Conclusion the accuracy of localization and diagnosis of cubital tunnel syndrome can be improved by the combination of nerve electrophysiology and MRI. The increase of ulnar nerve CSAR in all parameters of MRI has the best diagnostic accuracy.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R688
【参考文献】
相关期刊论文 前4条
1 陆建中,韦标方,黄海;肘管综合征的诊断与治疗[J];青岛医学院学报;1997年01期
2 陈浩;梁炳生;;肘管综合征研究进展[J];国际骨科学杂志;2010年03期
3 崔丽英,汤晓芙;肌电图的临床应用进展[J];临床神经电生理学杂志;2004年03期
4 王集锷,刘晓阳;肘部尺神经卡压症的诊断与治疗[J];山东医药;2002年12期
本文编号：2330067
本文链接：https://www.wllwen.com/yixuelunwen/fangshe/2330067.html
