高频超声对上肢尺神经正常值的研究

目的:通过高频超声获取尺神经的横截面积(cross-sectional area,CSA)正常值并探讨其与周围组织的关系,为进一步诊断不同的外周神经疾病提供依据。方法:对临床检查正常的200例健康志愿者沿尺神经预定的测量点上依次获取超声声像图及测量各点神经的CSA,每个测量点重复测量三次取其平均值,并做神经CSA与身高、体重的相关性分析。结果:超声下正常人上肢神经呈筛网状低回声图像,横截面呈圆形、卵圆形或三角形。测量尺神经各测量点处的神经CSA,尺神经在肘管、肘管出口(肱骨内髁下2cm)、肘管入口(肱骨内髁上2cm)、肱骨内髁上6cm、肱骨中点、肱骨内髁下8cm、腕横纹上6cm、Guyon管等8点处面积依次是(6.35±1.48)mm2、(6.20±1.33)mm2、(6.30±1.40)mm2、(5.78±1.34)mm2、(5.68±1.31)mm2、(5.71±1.26)mm2、(5.06±1.30)mm2、(4.71±1.16)mm2;左右上肢之间同一测量点比较神经CSA没有统计学意义,尺神经在肘管出入口、腕横纹上6cm、Guyon管处等四点处的神经CSAs同年龄组男女之间比较有统计学意义;尺神经在肱骨内髁上6cm、肱骨中点、腕横纹上6cm、Guyon管等4点处中老年组神经比青年组神经增粗。尺神经CSA与身高、体重呈正相关性。尺神经CSA与体重的最大相关系数分别是0.47(P<0.01),与身高的最大相关性系数依次是0.45(P<0.01)。结论:尺神经在上肢全程是可视,在不同测量点各有特点正常值不同,在性别、年龄阶段之间存在差异,身高、体重与神经的大小呈正相关性。

Study of ulnar nerve normal value measurment by high frequency ultrasonography

Objective To measure the cross-sectional area(CSA) value of ulnar nerve by high frequency ultrasonography,and to explore its relationship with surrounding tissues,in order to provide evidence for diagnosis of peripheral nerve disease.Method The ultrasounic images of ulnar nerve of 200 volunteers were got by high-resolution ultrasonography,and CSA of ulnar nerve were measured at predetermined sites.Results The upper limb nerve was a mesh-like low echo images.the cross section of nerve was round,oval,or triangular The CSA of ular nerve at different points.were obtained:the cubital tunnel(6.35 ± 1.48)mm2;cubital tunnel outlet(6.20 ± 1.33) mm2;cubital tunnel inlet(6.30 ± 1.40)mm2;Upon the medial epicondyle(5.78 ± 1.34)mm2,mid-humerus(mid-point between elbow crease and axilla,MH(5.68 ± 1.31)mm2;8 cm under the medial epicondyle(5.71 ± 1.26)mm2;6cm upon the wrist crease(5.06 ± 1.30) mm2,Guyon tunnel(4.71 ± 1.16) mm2.While CSA at cubital tunnel outlet,cubital tunnel inlet,WCP 6 cm and Guyon tunnel were statistically significant between men and women in the same age group.Ular nerve upon the medial epicondyle,at mid-humerus,WCP 6 cm and Guyon tunnel were thicker in elderly group than in young group.The maximum correlation coefficients was 0.47(P < 0.01) between CSA with weight,and 0.45(P < 0.01) with height.Conclusions The ulnar nerve is easily visualized along its entire course.The normal values at different sites are significant different,and significant different,between sexes and ages.The nerve size is positively correlated with height and weight.