您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报(医学版) ›› 2016, Vol. 54 ›› Issue (11): 72-75.doi: 10.6040/j.issn.1671-7554.0.2015.1087

• 临床医学 • 上一篇    下一篇

MR扩散加权神经成像技术对腕管综合征的诊断价值

包洪靖1,王光彬2,王姗姗2,吴超2   

  1. 1.内蒙古兴安盟人民医院超声科, 内蒙古 乌兰浩特 137400;2.山东省医学影像学研究所磁共振诊断室, 山东 济南 250021
  • 收稿日期:2015-11-09 出版日期:2016-11-10 发布日期:2016-11-10
  • 通讯作者: 王光彬. E-mail:guangbinWMRI@outlook.com E-mail:guangbinWMRI@outlook.com

Diffusion-weighted MR neurography of the median nerve in carpal tunnel syndrome: a preliminary study

BAO Hongjing1, WANG Guangbin2, WANG Shanshan2, WU Chao2   

  1. 1. Department of Ultrasound, Peoples Hospital of Xingan League, Ulan Hot 137400, Inner Mongolia, China;
    2. Shandong Medical Imaging Research Institute, Jinan 250021, Shandong, China
  • Received:2015-11-09 Online:2016-11-10 Published:2016-11-10

摘要: 目的 通过受试者工作特征曲线(ROC)比较高频超声、磁共振扩散加权神经成像技术(DW-MRN)对腕管综合征(CTS)的诊断价值。 方法 选取2014年2月至2015年8月CTS患者14例(17只手腕,CTS组)和健康志愿者13例(正常对照组,19只手腕)。两组行DW-MRN扫描,由2位阅片者独立测量腕管内豌豆骨水平正中神经的表观扩散系数(ADC),并同时行高频超声测量横截面积(CSA)。采用Student t检验检测CTS组和正常对照组腕管内正中神经CSA 和ADC值的差异,并进行ROC分析。 结果 CTS组与正常对照组腕管内正中神经CSA 和ADC值差异有统计学意义(P均<0.001)。CTS组CSA的ROC曲线下面积较ADC值高(AUC>0.8),两者诊断效能差异无统计学意义(P>0.05)。 结论 DW-MRN对CTS具有较好的诊断效能,与目前临床公认的高频超声诊断效能相当。

关键词: 扩散加权神经成像, 超声检查, 核磁共振, 腕管综合征

Abstract: Objective To compare the diagnostic value of diffusion-weighted MR neurography(DW-MRN)and ultrasonography of median nerve(MN)lesion in carpal tunnel syndrome(CTS). Methods A total of 13 healthy volunteers(19 wrists, control group)and 14 CTS patients(17 wrists, patient group)were included. The ultrasound(US)and DW-MRN were used to detect the MN at the level of pisiform bone. The cross-sectional area(CSA)and apparent diffusion coefficient(ADC)were calculated by two independent inspectors. Receiver operating characteristic(ROC)curve was drawn to assess the diagnostic efficiency. Results There were significant differences on the CSA and ADC between control group and patient group(both P<0.001). The area under curve(AUC)of CSA was higher than that of ADC in the diagnosis of CTS(AUC>0.8). No significant difference of diagnostic value was found between DW-MRN and US(P>0.05). Conclusion DW-MRN has good diagnostic efficiency for the MN in carpal tunnel syndrome, and has equal efficiency as US.

Key words: Magnetic resonance imaging, Carpal tunnel syndrome, Diffusion-weighted, Ultrasonography

中图分类号: 

  • R445
[1] 田东, 韩峰. 电生理检查在正中神经返支卡压征诊断的应用[J]. 现代电生理学杂志, 2013, 20(3): 157-159.
[2] 刘慧,郭徐林,陈定章, 等. 超声扫查正常成人臂丛神经根[J].中国医学影像技术, 2011, 27(5): 1021-1024. LIU Hui, GUO Xulin, CHEN Dingzhang, et al. Ultrasonography in observing the root level brachial plexus in normal adults[J]. Chin J Med Imaging Technol, 2011, 27(5): 1021-1024.
[3] 傅强, 崔立刚, 李志强, 等. 腕管内正中神经变异的声像图表现及其临床意义[J]. 中华超声影像学杂志, 2012, 21(10): 884-887. FU Qiang, CUI Ligang, LI Zhiqiang, et al. Sonographic appearance and clinical significance of anatomic variation of carpal tunnel median nerve[J]. Chin J Ultrasonogr, 2012, 21(10): 884-887.
[4] 王姗姗, 陈立光, 王光彬, 等. MR扩散加权神经成像显示腕掌部正中神经和尺神经及分支的价值[J]. 中华放射学杂志, 2014, 48(8): 686-689. WANG Shanshan, CHEN Liguang, WANG Guangbin, et al. Value of MR diffusion weighted neurography in median nerve and ulnar nerve[J]. Chin J Radiol, 2014, 48(8): 686-689.
[5] 王姗姗, 石红岭, 赵连新, 等. MR扩散加权神经成像技术在非创伤性上肢神经扭转中的应用[J].中华放射学杂志, 2015, 49(3): 209-212. WANG Shanshan, SHI Hongling, ZHAO Lianxin, et al. Application of diffusion-weighted MR neurography in nontraumatic upper limb nerve torsion[J]. Chin J Radiol, 2015, 49(3): 209-212.
[6] Ding WQ, Zhou XJ, Tang JB, et al. Three-dimensional display of peripheral nerves in the wrist region based on MR diffusion tensor imaging and maximum intensity projection post-processing[J]. Eur J Radiol, 2015, 84(6): 1116-1127.
[7] 赵连新, 王光彬, 刘玉波, 等. 不同扩散敏感梯度方向扩散加权MR神经成像序列胫神经与腓总神经成像质量的比较[J]. 中华放射学杂志, 2014, 48(3): 227-231. ZHAO Lianxin, WANG Guangbin, Liu Yubo, et al. Diffusion-weighted MR neurography of the tibial nerve and the common peroneal nerve with different motion probing gradients[J]. Chin J Radiol, 2014, 48(3): 227-231.
[8] Reinhold M, Ederer C, Henninger B, et al. Diffusion-weighted magnetic resonance imaging for the diagnosis of patients with lumbar nerve root entrapment syndromes: results from a pilot study[J]. Eur Spine J, 2015, 24(2): 319-326.
[9] Filler AG, Kliot M, Howe FA, et al. Application of magnetic resonance neurography in the evaluation of patients with peripheral nerve pathology[J]. J of Neurosugery, 1996, 85(2): 299-309.
[10] Mannelli L, Nougaret S, Vargas HA, et al. Advances in diffusion-weighted imaging[J]. Radiol Clin North Am, 2015, 53(3): 569-581.
[11] Lindberg PG, Feydy A, Le Viet D, et al. Diffusion tensor imaging of the median nerve in recurrent carpal tunnel syndrome-initial experience[J]. Eur Radiol, 2013, 23(11): 3115-3123.
[12] Eguchi Y,Ohtori S, Yamashita M, et al. Diffusion-weighted magnetic resonance imaging of symptomatic nerve root of patients with lumbar diskherniation[J]. Neuroradiology, 2011, 53(9): 633-641.
[13] Miyamoto H, Halpern EJ, Kastlunger M, et al. Carpal tunnel syndrome: diagnosis by means of median nerve elasticity improved diagnostic accuracy of US with sonoelastography[J]. Radiology, 2014, 270(2): 481-486.
[14] Fowler JR, Gaughan JP, Ilyas AM. The sensitivity and specificity of ultrasound for the diagnosis of carpal tunnel syndrome: a meta-analysis[J]. Clin Orthop Relat Res, 2011, 469(4): 1089-1094.
[15] Koh DM, Collins DJ, Orton MR. Intravoxel incoherent motion in body diffusion-weighted MRI: reality and challenges[J]. AJR Am J Roentgenol, 2011,196(6): 1351-1361.
[1] 徐平 于国放 李霞. 不同类型甲状腺上动脉PSV对Graves病与桥本氏甲状腺炎鉴别诊断的价值[J]. 山东大学学报(医学版), 2209, 47(6): 62-64.
[2] 金晨曦,沈薇,李娜,孙建锋,杨驰,郭泾. ADDWoR关节镜下盘复位术盘-髁运动的定量分析[J]. 山东大学学报 (医学版), 2025, 63(7): 54-61.
[3] 王磊,常霄,王梓萌,李娇娇,崔书君,杨飞,朱月香. 瘤内及瘤周DCE-MRI影像组学对宫颈癌患者无进展生存期的预测价值[J]. 山东大学学报 (医学版), 2025, 63(6): 45-54.
[4] 孙婧,杨瑞敏,王聪,张月,罗兵. 基于术前超声、炎症指标及超声影像组学联合模型预测乳腺癌腋窝淋巴结转移[J]. 山东大学学报 (医学版), 2025, 63(1): 73-80.
[5] 刘学业,李齐明,唐弘毅,徐秋平,陈文倩,郭泾. 年轻成人颞下颌关节髁突体积、表面积与关节盘矢向位置的关系[J]. 山东大学学报 (医学版), 2021, 59(6): 117-121.
[6] 商蒙蒙,张岩,程琳,孙霄,时丹丹,闵香,李杰. 弹性应变率比值法与声触诊组织量化技术对乳腺肿块的诊断价值[J]. 山东大学学报 (医学版), 2019, 57(6): 94-99.
[7] 毛羽,周昕. 超声检查对小儿十二指肠梗阻性疾病的诊断价值[J]. 山东大学学报 (医学版), 2018, 56(2): 47-50.
[8] 范凤景,张广英,曹淑娟,丁红宇,刘德泉. 声触诊组织量化技术在乳腺肿块定性诊断中的价值[J]. 山东大学学报(医学版), 2016, 54(9): 48-52.
[9] 吴世秀,李杰,贾汇刚,李金娥,崔琳玲,路红. 彩色多普勒超声对下肢动脉硬化闭塞症胫前动脉窃血的诊断价值[J]. 山东大学学报(医学版), 2016, 54(6): 78-81.
[10] 刁晓君,陈春富,李聪聪,张颖博,李婴婴. 多发性硬化患者原发性头痛的特征及发病情况[J]. 山东大学学报(医学版), 2016, 54(4): 42-45.
[11] 梁军利,许予明. 高频超声和电生理检查对中期腕管综合征患者疗效判定[J]. 山东大学学报(医学版), 2016, 54(3): 59-62.
[12] 李进叶,宋歌声,宋吉清,王大伟,靳先文,张成琪. 宝石能谱CT与常规超声对甲状腺结节良恶性诊断价值的对照分析[J]. 山东大学学报(医学版), 2016, 54(3): 81-86.
[13] 钱海燕,王兴朝,刘丕楠. 垂体腺瘤致视力障碍患者视觉皮层及相关功能网络静息状态局部一致性的改变[J]. 山东大学学报(医学版), 2016, 54(10): 60-65.
[14] 王凤雪, 王倩, 李桂梅, 胡艳艳, 王增敏. 垂体柄阻断综合征患儿垂体核磁共振表现与功能损伤的相关性[J]. 山东大学学报(医学版), 2015, 53(1): 58-62.
[15] 初海鹏, 谭秀梅, 卢战凯. 阴道超声和血绒毛膜促性腺激素联合检测在异位妊娠诊断中的应用[J]. 山东大学学报(医学版), 2014, 52(Z1): 138-139.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!