高频超声在上肢外周神经损伤中的诊断价值

目的探讨高频超声对外周神经损伤的诊断价值。方法用高频超声检查了15例正常上肢外周神经及8例术前上肢外周神经损伤患者。结果正常外周神经纵切面超声表现为中等条索状,内有线性平行回声,横切面呈圆形,内有点状回声,2例外周神经完全损伤,连续性中断,近端形成损伤性神经瘤。6例外周神经部分损伤,连续性部分中断,部分近端形成神经瘤。结论高频超声对外周神经损伤能提供新的影像诊断方法。     

高频超声诊断四肢外周神经损伤的临床价值

目的探讨高频超声在外周神经损伤中的诊断价值。方法高频超声检查30例健康志愿者,了解正常外周神经超声图像的基础上,对临床40例外周神经损伤于术前行超声检查,并用术中所见及病理学检测结果证实超声诊断价值。结果正常外周神经纵切声像图为多条平行线性回声的束状结构。外周神经完全断裂,可见束状结构连续性中断,近端形成神经瘤,外周神经肿胀粘连,显示神经增粗,束状结构回声界限模糊不清。卡压性损伤可见神经变细,内部呈低回声改变。超声与术中所见及病理检测结果的符合率达87．5％。结论高频超声检查对外周神经损伤有较好的诊断价值,对临床治疗和选择手术方案有重要指导意义。     

高频超声在外周神经损伤中的应用

外周神经损伤后,早期诊断有助于选择最佳的治疗时机及方案,从而最大限度地恢复神经功能[1].本研究将高频超声诊断技术用于外周神经损伤病例,发现其对神经损伤的诊断有一定的辅助诊断价值,并能指导治疗及随访术后患者以评价手术效果.资料与方法一、研究对象2009年5月至2011年3月行超声检查并经手术、病理证实的资料完整的外周神经损伤患者45例,男36例,女9例,年龄11～63岁,平均(33±2)岁,病程7d至4年.损伤原因:创伤性损伤27例(其中锐器切割伤23例,钝器挫裂伤4例),卡压性损伤12例,神经肿瘤源性损伤3例,神经离断3例.     

超声技术在周围神经损伤中的应用及研究进展

<正>周围神经损伤的发病原因复杂,主要包括创伤性损伤、局部卡压、神经肿瘤等。早期的准确诊断和适当的治疗策略是周围神经损伤获得良好预后的关键。超声技术是利用超声波的物理特性和生物组织的声学特性进行成像的检查技术,由于与传统的神经电生理、核磁共振等检查技术相比具有经济、无创、实时动态成像等优势,已成为周围神经损伤诊断的重要工具。近年来,随着超声技术的发展,其在周围神经及相关肌肉和血管的检查方面获得了新的进展。此外,超声技术不仅在周围神经损伤诊断领域有所突破,     

超声诊断外周神经病变的临床价值

目的探讨高频超声在外周神经病变和损伤中的诊断价值。方法应用高频超声检查15例正常查体肢体外周神经、12例外周神经损伤及6例神经肿瘤，术前超声检查与术中探查结果作比较分析。结果正常神经纵切面声像图为多条线性的平行较强回声；横切面为圆形中等回声结构，中心为点状强回声。2例外周神经完全离断，显示连续性中断，近端形成神经瘤；7例外周神经部分损伤，显示连续性部分中断；3例卡压性损伤，神经水肿增粗，内部呈束状低回声不清晰。6例神经肿瘤与神经相连续。结论高频超声可作为外周神经病变和损伤首选的检查方法，值得临床推广应用。     

高频超声在外伤致周围神经损伤诊断中的应用

正周围神经损伤的诊断以往多依靠临床体格检查及神经电生理检查,并不能准确提供神经损伤的部位、病因及程度,而高频超声能准确地探查人体大部分周围神经,可以评估周围神经受损情况。本组回顾性分析我院45例周围神经损伤患者的超声图像,旨在评价高频超声对于周围神经损伤的诊断价值。资料与方法一、临床资料选取2013年4月至2016年2月我院周围神经损伤患者     

高频超声在周围神经疾病诊断及治疗效果评价中的价值

目的探讨高频超声在周围神经疾病诊断及治疗效果评价中的临床价值。方法回顾性分析39例周围神经疾病患者的超声表现,并与术中及病理结果对照。结果外周神经创伤性损伤15例,外周神经卡压16例,肢体外周神经源性肿瘤8例。超声对神经损伤、神经卡压及神经肿瘤的诊断符合率分别为73.3%、100%、62.5%。行神经吻合术患者中,16例神经束由吻合口近端向远端延伸,提示神经通路建立;5例吻合口明显膨大,吻合口内神经束对位较差;2例吻合处缩窄,提示神经通路未建立。结论高频超声在诊断四肢周围神经疾病方面能精确判断损伤部位,较准确评估损伤的程度,为临床提供重要的诊断信息,有助于临床治疗方案的制定,同时能及时直观地评价神经损伤的治疗效果。     

实时超声弹性成像评估外周神经损伤

目的 探讨实时超声弹性成像（RTE）评估外周神经损伤的价值。方法 对52例疑诊外周神经损伤患者进行常规超声和RTE扫查,以5分制评价RTE弹性图像;将RTE评分、常规超声及联合应用两者诊断外周神经损伤的结果分别与手术结果进行对照。结果 RTE、常规超声及联合应用两者评估外周神经损伤的敏感度分别为72.09%（31/43）、69.77%（30/43）、95.35%（41/43）,特异度分别为33.33%（3/9）、44.44%（4/9）、66.67%（6/9）,准确率分别为65.38%（34/52）、65.38%（34/52）、90.38%（47/52）;联合应用二者诊断外周神经损伤的敏感度、准确率及阴性预测值均高于单独RTE评分及常规超声（P<0.05）。结论 联合应用RTE和常规超声可提高超声评估外周神经损伤的准确率,为临床治疗及术式选择提供参考依据。     

心脏及外周血管超声对肺栓塞患者的诊断价值研究

目的:探讨心脏及外周血管超声对肺栓塞患者的诊断价值。方法:选取2019年3月—2022年3月单县中心医院收治的110例疑似肺栓塞患者,均开展心脏超声、外周血管超声单一及联合检测,以临床综合诊断结果为金标准,对比心脏超声检查、外周血管超声检查、心脏联合外周血管超声诊断肺栓塞的效能,分析在肺栓塞诊断中不同检测方式与临床综合诊断结果之间的一致性,并对比不同检测方式对于肺栓塞患者不同栓塞程度诊断的符合率。结果:在110例疑似肺栓塞患者中,经临床综合诊断,有68例患者确诊肺栓塞,其余42例患者排除肺栓塞。心脏联合外周血管超声诊断的灵敏度、特异度、准确率、阳性预测值、阴性预测值均显著高于心脏超声检查、外周血管超声检查(P<0.05);而心脏超声检查与外周血管超声检查的灵敏度、特异度、准确率、阳性预测值、阴性预测值对比,差异均无统计学意义(P> 0.05)。肺栓塞诊断一致性分析,心脏超声、外周血管超声检查结果与临床综合诊断结果均具有中度一致性,心脏联合外周血管超声检查结果与临床综合诊断结果具有高度一致性。对于高危、中危肺栓塞检测,心脏超声检查、外周血管超声检查、心脏联合外周血管超声检查的...     

高频超声在外周神经损伤中的应用价值

目的:关于高频超声应用在外周神经损伤诊断当中的效果分析.方法:选择我院在2018年1月到2019年6月收治的疑似外周神经损伤患者66例作为调查对象,所有患者在进行治疗之前均采用高频超声进行诊断,判断高频超声和临床病理诊断的符合性.结果:66例患者经过临床病理诊断确诊为外周神经损伤患者63例,而通过高频超声进行诊断,诊断为外周神经损伤患者60例,占90.91%,诊断的敏感性为95.24%,特异性为100.00%,准确性为95.45%.结论:临床对外周神经损伤进行诊断时应用高频超声可以实现对患者良好的鉴别,能有效提升临床诊断的整体效率,可作为有效的辅助诊断工具加以推广应用.     

高频超声评价创伤性周围神经损伤的进展

高频超声在创伤性周围神经损伤中具有重要价值。近年来,随着超声工程学的进展和探测技术的提高,高频超声可以更细微地显示周围神经损伤的细节以及与周围组织结构的关系。本文主要就周围神经超声探测方法、周围神经损伤的超声分级诊断和皮神经损伤等应用和进展进行综述。     

Differentiation of Neural Stem/Progenitor Cells Using Low-Intensity Ultrasound

Herein, we report the evaluation of apoptosis, cell differentiation, neurite outgrowth and differentiation of neural stem/progenitor cells (NSPCs) in response to low-intensity ultrasound (LIUS) exposure. NSPCs were cultured under different conditions, with and without LIUS exposure, to evaluate the single and complex effects of LIUS. A lactic dehydrogenase assay revealed that the cell viability of NSPCs was maintained with LIUS exposure at an intensity range from 100 to 500 mW/cm². Additionally, in comparison with no LIUS exposure, the cell survival rate was improved with the combination of medium supplemented with nerve growth factor and LIUS exposure. Our results indicate that LIUS exposure promoted NSPC attachment and differentiation on a glass substrate. Neurite outgrowth assays revealed the generation of longer, thicker neurites after LIUS exposure. Furthermore, LIUS stimulation substantially increased the percentage of differentiating neural cells in NSPCs treated with nerve growth factor in comparison with the unstimulated group. The high percentage of differentiated neural cells indicated that LIUS induced neuronal networks denser than those observed in the unstimulated groups. Furthermore, the release of nitric oxide, an important small-molecule neurotransmitter, was significantly upregulated after LIUS exposure. It is therefore reasonable to suggest that LIUS promotes the differentiation of NSPCs into neural cells, induces neurite outgrowth and regulates nitric oxide production; thus, LIUS may be a potential candidate for NSPC induction and neural cell therapy.     

低强度超声在脑神经疾病治疗中的应用进展

近年来,随着超声波生物学效应的深入研究,低强度超声(LIUS)经颅脑刺激治疗脑神经疾病因具有无创、高空间分辨率及高性价比等优点,逐渐成为研究热点。LIUS主要通过非热效应发挥作用,在脑神经疾病(如创伤性颅脑损伤、缺血性脑卒中、阿尔茨海默病等)的治疗中取得了较好的疗效。本文就该技术在脑神经疾病治疗中的研究进展进行综述。     

地震致周围神经损伤的超声特征

目的 探讨地震所致周围神经损伤患者的晚期超声特征。方法 对34例地震所致周围神经损伤患者于伤后1年行高频超声检查,并与手术结果比较。结果 34例患者中,超声检出周围神经异常68条;9例为1条神经损伤, 17例2条神经损伤,8例累及3条及以上神经损伤。其中神经与周围瘢痕组织粘连、卡压48条,神经完全断裂6条,神经吻合术后5条,截肢术后神经末端创伤性神经瘤形成9条。超声与手术结果的符合率为97.06%。结论 地震所致周围神经损伤晚期以多条神经同时受损、1条神经多处损伤为特征,主要为瘢痕粘连、卡压所致。超声可对神经损伤进行定性和定位诊断。     

Preventing Perioperative Peripheral Nerve Injuries

Peripheral nerve injuries are largely preventable injuries that can result from incorrect patient positioning during surgery. Patients who are diabetic, are extremely thin or obese, use tobacco, or undergo surgery lasting more than four hours are at increased risk for developing these injuries. When peripheral nerve injuries occur, patients may experience numbness, burning, or tingling and may have difficulty getting out of bed, walking, gripping objects, or raising their arms. These symptoms can interrupt activities of daily living and impede recovery. Signs and symptoms of peripheral nerve injury may appear within 24 to 48 hours of surgery or may take as long as a week to appear. Careful attention to body alignment and proper padding of bony prominences when positioning patients for surgery is necessary to prevent peripheral nerve injury. The use of a preoperative assessment tool to identify at-risk patients, collaboration between physical therapy and OR staff members regarding patient positioning, and neurophysiological monitoring can help prevent peripheral nerve injuries.     

Musculocutaneous nerve injury after simulated freefall in a vertical wind-tunnel: a case report

We report a case of a skydiver with isolated musculocutaneous nerve injury, which occurred after prolonged positioning of the arm during simulated freefall in a vertical wind-tunnel. Musculocutaneous nerve injury is rare, and the mechanism of isolated injury to this nerve is not entirely understood. Isolated peripheral nerve injuries such as this easily mimic other injuries and can be difficult to diagnose. The skydiver complained of right arm weakness and numbness that began after training in a vertical wind-tunnel. Exam revealed weakness in right elbow flexion and forearm supination, and diminished sensation in the right lateral forearm. Electrodiagnostic testing revealed a decreased amplitude in the right lateral antebrachial cutaneous nerve sensory nerve action potential, and fibrillations and positive sharp waves in the biceps and brachialis muscles. By 5 months, the subject reported complete sensory and motor recovery. Physical and electrodiagnostic findings corresponded to the distribution of the musculocutaneous nerve. The mechanism of injury was likely the prolonged abducted, extended, and externally rotated position of the shoulder during simulated freefall. Although isolated nerve injuries are uncommon, unusual activities and physiologic demands of athletes can result in such injuries. It is important to be aware of peripheral nerve injuries to facilitate proper diagnosis and management.     

低强度超声在脑神经疾病治疗中的应用研究进展

经颅直流电刺激,经颅磁刺激和深部脑刺激等神经调控技术已在多种神经/精神疾病(如帕金森,癫痫,抑郁症)的治疗中得到广泛应用,但仍存在直流电刺激深度浅、经颅磁刺激刺激精度受限等局限性。近年来,随着对超声波生物学效应的研究进展,低强度超声(SLIUS)经颅脑刺激这种新的神经调控治疗脑神经疾病的方法,因其具有无创、高空间分辨率以及高性价比等优点,而备受研究者青睐。LIUS主要通过非热效应发挥作用,在诸多脑神经疾病(如：创伤性颅脑损伤、缺血性脑卒中、阿尔茨海默病等)的治疗中取得了较大进展。现就该技术近年在脑神经疾病治疗中的主要研究进展及相关问题作一综述。     

The advances in nerve tissue engineering: From fabrication of nerve conduit to in vivo nerve regeneration assays

Peripheral nerve damage is a common clinical complication of traumatic injury occurring after accident, tumorous outgrowth, or surgical side effects. Although the new methods and biomaterials have been improved recently, regeneration of peripheral nerve gaps is still a challenge. These injuries affect the quality of life of the patients negatively. In the recent years, many efforts have been made to develop innovative nerve tissue engineering approaches aiming to improve peripheral nerve treatment following nerve injuries. Herein, we will not only outline what we know about the peripheral nerve regeneration but also offer our insight regarding the types of nerve conduits, their fabrication process, and factors associated with conduits as well as types of animal and nerve models for evaluating conduit function. Finally, nerve regeneration in a rat sciatic nerve injury model by nerve conduits has been considered, and the main aspects that may affect the preclinical outcome have been discussed.     

Imaging of peripheral nerve lesions in the lower limb

Lower limb peripheral neuropathy may have a variety of causes. This article focuses on focal neural lesions because of neural entrapment associated with static mechanical compression or dynamic compression/stretching. Mechanical compression may relate to direct blunt trauma, surgical injury, mass effect associated with adjacent mass lesions, and frictional effects associated with fibrous bands. Stretching neural injury may be associated with abnormalities in alignment such as plano-valgus hindfoot and hindfoot pronation. Recurrent inversion ankle injuries may also cause neural injury. Neural injury may be associated with denervation of the muscles supplied by the nerve. Electromyography (EMG) remains the gold standard for diagnosis of denervation. Diagnostic imaging plays a complementary role to EMG in difficult cases, the anticoagulated patient, and in clarifying the etiology of an EMG-demonstrated neuropathy. Magnetic resonance imaging and ultrasound can be used in peripheral nerve imaging to demonstrate extrinsic compressive lesions, focal neural lesions such as neural edema and swelling, focal neural scarring (posttraumatic neuroma in continuity) and intraneural ganglia. Imaging can also demonstrate the effects of muscle denervation. Focal areas of tenderness can be highlighted using skin markers for magnetic resonance imaging and by transducer palpation on ultrasound. Ultrasound can be particularly useful in assessing for intrinsic lesions in small peripheral nerves because of the superior spatial resolution of ultrasound in assessing superficial structures. Plain x-rays (and sometimes computed tomography scanning) may show significant bone changes and should be the initial imaging modality.