彩色多普勒超声在肘管综合征中的诊断作用和临床意义

发布时间：2018-01-26 20:42

本文关键词： 彩色多普勒超声肌电图 CTS 尺神经 CSA　出处：《内蒙古大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:研究彩色多普勒超声作为一种辅助检查手段在诊断肘管综合征(cubital tunnel syndrome,CTS)中的应用价值和临床意义。方法:取在临床上经过查体并结合肌电图检查已确诊的CTS患者50例(单侧肘关节患病,共计50只),同时选取无CTS及肘部外伤和排除了颈椎病等的健康志愿者50例(双侧正常肘关节,共计100只)作为对照组。对两组样本尺神经的连续性、内部结构变化、比邻关系用彩色多普勒超声做检查,通过测量及比较两组样本的尺神经在肘管段内的超声像图表现与尺神经的长轴径(long diameter of axle,LA)、短轴径(short diameter of axle,SA)、横截面积(cross sectional area,CSA)等各项指标间的差异,然后进行统计学分析。同时将术前彩色多普勒超声检查发现的形态学异常与术中所见进行对比,并将病例组的检测结果与术前肌电图检查结果作相关性分析研究,最后用ROC曲线评价彩色多普勒超声诊断CTS的准确性。结果:彩色多普勒超声不仅能够清楚地显示出尺神经的解剖走行和形态变化,同时还可以观察到尺神经周围的解剖结构。在彩色多普勒超声显示的尺神经形态学异常与手术所见保持一致,患者组的尺神经横截面积(CSA)的平均值要明显大于对照组,两者具有显著差异;患者组尺神经CSA与其运动传导速度(motor nerve conduction velocity,MNCV)的皮尔森(pearson,P)相关系数是-0.64,二者呈负相关。通过彩色多普勒超声测量尺神经CSA来诊断CTS的敏感度为88%,特异性为95%。结论:彩色多普勒超声作为一种既廉价简单安全又无创且可以重复操作的检查手段,其在临床上对CTS的诊断提供了可靠的诊断依据,而且对临床上选择CTS的治疗方式也有非常重要的指导价值。
[Abstract]:Objective: to study the application of color Doppler ultrasound in the diagnosis of cubital tunnel syndrome. Methods: 50 cases of CTS diagnosed by physical examination and electromyography (50 cases of unilateral elbow joint disease) were selected. At the same time, 50 healthy volunteers without CTS and elbow trauma and without cervical spondylopathy were selected as control group. The continuity of ulnar nerve in both groups was observed. The changes of internal structure were examined by color Doppler ultrasound. The ulnar nerve in the cubital tunnel was measured and compared with the long axis of the ulnar nerve and the long diameter of the ulnar nerve. Short diameter of sectional area. CSAs and other indicators of the differences, then statistical analysis. At the same time, the color Doppler ultrasound before operation found morphological abnormalities and intraoperative findings were compared. The correlation between the test results and the results of electromyography before operation was analyzed. Finally, the ROC curve was used to evaluate the accuracy of color Doppler ultrasound in the diagnosis of CTS. Results: color Doppler ultrasound could not only clearly show the anatomical course and morphological changes of ulnar nerve. At the same time, the anatomical structure around ulnar nerve could be observed. The morphological abnormality of ulnar nerve displayed by color Doppler ultrasound was consistent with that of operation. The mean value of CSAs in the patient group was significantly higher than that in the control group, and there was a significant difference between the two groups. Pearson Pearson of ulnar nerve CSA and motor motor nerve conduction velocityMNCV. The correlation coefficient was -0.64, which was negatively correlated. The sensitivity of detecting ulnar nerve CSA by color Doppler ultrasound was 88%. Conclusion: as a cheap, safe, non-invasive and repeatable method, color Doppler ultrasound provides a reliable diagnostic basis for the diagnosis of CTS. Moreover, it has very important guiding value to choose the treatment way of CTS in clinic.
【学位授予单位】：内蒙古大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R688

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