外周神经损伤的高频超声诊断研究

目的 探讨高频超声检查在外周神经损伤中的诊断价值。方法 在对新鲜截肢标本和志愿意者健全肢体进行检测，了解正常外周神经超声图像的基础上，对临床28例外周神经损伤的病例于术前作超声检查，并与术中探查结果作比较分析。结果 正常神经为有回声的束状结构。横切面则可见卵圆形结构。在创伤性病变，神经断裂时可见束状回声中断，神经粘连时可见束状回声界限模糊不清；在卡压性损伤可见内部低回声改变，而外膜回声增强；在神经肿瘤病变，可明确显示肿瘤与神经的关系。以术中所见为标准，超声诊断符合率为64％。结论 高频超声检查对外周神经损伤具有一定的辅助诊断价值，并可以指导治疗和随访。

Study of high-resolution ultrasonographic evaluation of peripheral nerve lesion in extremities

Objective To evaluate the diagnostic value of high resolution ultrasonography in peripheral nerve lesions Methods Sonographic examinations of peripheral nerves with 10 MHz probe were performed in vitro (fresh amputated specimen), in vivo (healthy volunteers), and in 28 patients with peripheral nerve lesions caused by trauma, compression and tumors preoperatively Sonograms were compared with the corresponding intraoperative findings Results The normal nerve displayed and echogenic fascicular texture with round to oval corss sectional structure on both in vitro and in vivo sonograms In traumatic lesions, the interruption of fascicular pattern reflected the disruption of nerve, and ill delineated fascicular pattern indicated nerve adhesion Centrally hypoechoic and peripherally hyperechoic changes were seen in compressive lesions Definitive relations between nerve and tumor were demonstrated in case of nerve tumor The diagnostic rate by ultrasonography was 64% when the intraoperative findings were regarded as criteria Conclusion Ultrasonography is of some diagnostic value and may have great potential to help direct treatment and follow up in peripheral nerve lesions