【摘要】：目的 探討神經(jīng)電生理聯(lián)合MRI檢查在診斷肘管綜合征（CuTS）中的應(yīng)用價(jià)值。 方法 對(duì)23例肘管綜合征病人的患肘（30肘）和15例正常對(duì)照者的肘部（15肘）進(jìn)行神經(jīng)電生理和MRI檢查。測(cè)量肘段尺神經(jīng)運(yùn)動(dòng)傳導(dǎo)速度（MCV），測(cè)量肘段尺神經(jīng)卡壓點(diǎn)近端腫脹最明顯處及卡壓點(diǎn)處尺神經(jīng)橫切面積（CSA1,CSA2）和尺神經(jīng)相對(duì)信號(hào)強(qiáng)度（RSI1, RSI2），計(jì)算這兩處的CSA比值（CSA1/CSA2）和RSI比值（RSI1/RSI2），即得CSAR、RSIR。將不同層面、分組的尺神經(jīng)MRI參數(shù)進(jìn)行獨(dú)立樣本t檢驗(yàn)。將肘段MCV分別與CSA1、RSI1、CSAR、RSIR進(jìn)行相關(guān)性分析。以臨床及電生理診斷作為參考標(biāo)準(zhǔn)，，將MRI參數(shù)進(jìn)行受試者工作特征(ROC)曲線分析。 結(jié)果 病例組CSA1、RSI1較CSA2、RSI2顯著增大（P0.05）。病例組的CSA1、RSI1、CSAR、RSIR皆較對(duì)照組顯著增大（P0.05）。病例組MCV與CSA1呈負(fù)相關(guān)（r=-0.62）、與CSAR呈負(fù)相關(guān)（r=-0.53），MCV與RSI1、RSIR無(wú)相關(guān)性。CSAR的ROC曲線下面積最大0.94（95%CI，0.83-1），最佳截?cái)嘀禐?.83，診斷肘管綜合征的敏感性為93.3%，特異性為80%。 結(jié)論 神經(jīng)電生理聯(lián)合MRI檢查能夠提高肘管綜合征的定位診斷準(zhǔn)確率，MRI各參數(shù)中尺神經(jīng)CSAR的增加具有最佳診斷準(zhǔn)確性。
[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.
【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R445.2;R688

【參考文獻(xiàn)】

相關(guān)期刊論文 前4條

1 陸建中,韋標(biāo)方,黃海;肘管綜合征的診斷與治療[J];青島醫(yī)學(xué)院學(xué)報(bào);1997年01期

2 陳浩;梁炳生;;肘管綜合征研究進(jìn)展[J];國(guó)際骨科學(xué)雜志;2010年03期

3 崔麗英,湯曉芙;肌電圖的臨床應(yīng)用進(jìn)展[J];臨床神經(jīng)電生理學(xué)雜志;2004年03期

4 王集鍔,劉曉陽(yáng);肘部尺神經(jīng)卡壓癥的診斷與治療[J];山東醫(yī)藥;2002年12期

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