A Pilot Study of Strain Elastography in the Diagnosis of Carpal Tunnel Syndrome.
A Pilot Study of Strain Elastography in the Diagnosis of Carpal Tunnel Syndrome.
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DOI：
10.1097/wnp.0000000000000334
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发表时间：
2017-03
期刊：
影响因子：
--
通讯作者：
Cartwright MS
中科院分区：
文献类型：
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作者：
Martin MJ;Cartwright MS
使用身体的心肺脉动来确定组织硬度的应变弹性成像（在此称为“环境应变弹性成像”）先前未被描述用于腕管综合征的评估。本研究的目的是评估超声环境应变弹性成像在评价腕管综合征中的可靠性，并比较患者和健康对照组之间的正中神经僵硬度。环境应变弹性成像被用来检查17例患者和26个控制手腕的横截面和纵向视图，两次由两名观察员。获得正中神经和附近肌腱之间的应变比，并测试评估者内和评估者间的可靠性以及患者和健康对照组之间的差异。即使对于经验较少的评分者，评分者内和评分者间的可靠性也很强（最低r=0.566，最高r=0.905;所有比较p<0.001）。腕管综合征患者和对照组之间的应变率无显著差异（横断面图像p=0.32;纵向图像p=0.20）。应变比与腕管综合征的传统超声测量值无显著相关性（最低p=0.26），但如果从横断面图像获得，则与体重指数显著相关（r=0.346; p=0.02）。这种应变弹性成像方法是可靠的，但不能显示腕管综合征正中神经僵硬的变化。体重指数可能会影响弹性成像，应进行进一步的研究，以澄清这种关系。
Strain elastography that uses the body’s cardiorespiratory pulsations to determine tissue stiffness (referred to here as “ambient strain elastography”) has not been previously described for the assessment of carpal tunnel syndrome. The objective of this study is to assess the reliability of ultrasonographic ambient strain elastography in the evaluation of carpal tunnel syndrome and compare median nerve stiffness between patients and healthy controls. Ambient strain elastography was used to examine 17 patient and 26 control wrists in cross-sectional and longitudinal views, twice by two observers. The strain ratio between the median nerve and nearby tendons was obtained and tested for intra- and inter-rater reliability and differences between patients and healthy controls. Intra- and inter-rater reliabilities were strong, even for the less experienced rater (lowest r=0.566, highest r=0.905; p<0.001 for all comparisons). No significant difference in strain ratio between those with carpal tunnel syndrome and controls was detected (cross-sectional image p=0.32; longitudinal image p=0.20). Strain ratio did not correlate significantly with traditional ultrasound measures of carpal tunnel syndrome (lowest p=0.26), but did correlate significantly with body mass index if obtained from cross-sectional images (r=0.346; p=0.02). This strain elastography method is reliable but does not show changes in median nerve stiffness with carpal tunnel syndrome. Body mass index may influence elastography and further studies should be conducted to clarify this relationship.