An Experimental Investigation into Staging CTS Utilizing Portable Ultrasound...

描述（由申请人提供）：使用医学超声对正中神经进行成像并不被认为是一种新的诊断工具，然而，使用带有高频换能器和功率多普勒的便携式装置是监测工作场所发生的肌肉骨骼疾病的一种创新的非侵入性替代方法。进一步探索使用超声波作为健康监测工具来监测CTS风险较高的职业中工人正中神经健康的潜力也是创新的。因此，该提案的中心假设是，具有高频换能器和能量多普勒的医学超声可以提供正中神经的监测，并记录CTS的发展和恢复。这将使用意志动物模型进行探索，以确定多普勒、灰度成像和检查组合（EDX、MRI和超声）的使用是否可以跟踪正中神经从基线到暴露结束直至恢复的病理变化。能量多普勒能够记录急性变化，如神经周围小动脉充血和血流量增加。灰阶多普勒能够记录与正中神经单神经病（MMN）相关的正中神经慢性变化。缺血性变窄或“切迹征”表示神经脱髓鞘。最后，MRI和EDX是难以在工作场所进行的测试，但它们被认为是临床标准，重要的是在8只食蟹猴中根据这些测量值对超声数据进行趋势分析，这些食蟹猴从基线到MMN恢复。该项目将有助于加速超声波的使用，在工作场所提供非侵入性和负担得起的诊断信息。 公共卫生相关性：本实验的平移影响将验证超声是一种非侵入性成像技术，用于监测由于重复腕-手任务而进展的MMN。人类受试者参与工作场所以外的贡献活动减轻了先前的工作。这项研究将允许评估MMN的进展和使用便携式超声作为跟踪正中神经病理学的动态和敏感手段的实用性。

DESCRIPTION (provided by applicant): The use of medical ultrasound, to image the median nerve, is not considered a new diagnostic tool however, the use of portable units with high frequency transducers and power Doppler are an innovative non-invasive alternative for monitoring musculoskeletal disorders occurring in the workplace. Further exploring the potential of using ultrasound as a health surveillance tool for monitoring the health of the median nerve in workers in occupations that are higher risk for CTS is also innovative. Therefore, the central hypothesis of this proposal is that medical ultrasound with high frequency transducers and power Doppler can provide surveillance of the median nerve and document development and recovery of CTS. This will be explored using a volition animal model to determine whether the use of Doppler, gray-scale imaging, and a combination of exams (EDX, MRI and ultrasound) can follow pathologic changes in the median nerve from baseline to end exposure through recovery. Power Doppler has the ability to record acute changes such as hyperemia and increased blood flow in the perineural arterioles. Gray-scale Doppler has the ability to record chronic changes to the median nerve associated with median mononeuropathy (MMN). An ischemic narrowing or "notch sign" signifies the demyelination of the nerve. Lastly MRI and EDX are tests that are difficult to perform in the workplace however they are considered a clinical standard and it is important to trend the ultrasound data against these measures in the 8 macaca fascicularis that are moving from baseline to recovery of MMN. This project will help to accelerate the use of ultrasound to provide both non-invasive and affordable diagnostic information in the workplace. PUBLIC HEALTH RELEVANCE: The translational impact of this experiment will be to verify that ultrasound is a non-invasive imaging technique for surveillance of MMN that progresses due to repetitive wrist-hand tasks. Previous work has been mitigated by human subject's involvement in contributory activities outside of the workplace. This study will allow for an assessment of the progression of MMN and the utility of using portable ultrasound as a dynamic and sensitive means for tracking median nerve pathology.