高频超声诊断周围神经损伤临床价值的探讨

目的 探讨高频超声在诊断周围神经系统疾病中的临床价值.方法 回顾性分析2003年1月至2006年12月手术治疗的64例周围神经损伤患者的临床资料,对手术病理结果和超声表现进行比较.结果 38例患者45支创伤性病变神经中,超声检查结果有38支与手术结果符合,占84.4%;在26例肿瘤性病变患者中超声提示肿物来源于神经16例,占约61.5%.其中四肢周围神经来源肿瘤15例,符合诊断的13例,占86.7%;非四肢周围神经来源肿瘤11例,符合诊断仅3例,占约27.3%.结论 高频超声在诊断四肢周围神经损伤上能精确判断损伤部位,较准确评估损伤的程度,能给临床提供重要的诊断信息;在周围神经肿瘤特别是发生于四肢的周围神经肿瘤的诊断上有一定应用价值.

The clinic value of high frequency ultrasound in diagnosis of peripheral nerve diseases

Objective To evaluate the clinical value of high frequency ultrasound in diagnosing peripheral nerve diseases (PNDs). Methods Sixty-four cases of PNDs were analyzed retrospectively. The ultrasound diagnosis was compared with the operative and pathological diagnosis. Results Based on the operative and histopathological results, in 38 patients with trauma or entrapment, 38 among 45 traumatic nerves were rightly diagnosed by ultrasound. The coincidence rate was 84.4%. In 26 patients with original peripheral nerve tumors (PNTs), including 20 neurilemomas, 4 neurofibromas and 2 malignant neurilemomas, 16 cases were diagnosis correctly by ultrasound with a coincidence rate of 61.5%. The coincidence rates in limbs and trunk were 86.7%（13/15）and 27.3%(3/11) respectively. Conclusions The study suggests that high frequency ultrasound can locate peripheral nerve trauma precisely, assessment the impair degree correctly and provide useful information for clinic diagnosis. The high frequency ultrasound brings better diagnosis outcome in limbs nerve tumors than in trunk.