MR扩散加权神经成像技术对腕管综合征的诊断价值

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。

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

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.