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设备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。进一步探索超声作为一种健康监测工具的潜力，用于监测CTS高风险职业工人的正中神经健康状况也是一种创新。因此，本研究的中心假设是，使用高频换能器和功率多普勒的医学超声可以监测正中神经，记录CTS的发展和恢复。这将通过动物模型进行探索，以确定多普勒、灰度成像和结合检查（EDX、MRI和超声）是否可以跟踪正中神经从基线到最终暴露到恢复的病理变化。功率多普勒有能力记录急性变化，如充血和神经周围小动脉血流量增加。灰度多普勒能够记录与中位单神经病变（MMN）相关的正中神经的慢性变化。缺血性狭窄或“缺口征”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，在从基线到MMN恢复的8只脉络膜猕猴中，将超声数据与这些措施相对照。该项目将有助于加速超声波的使用，在工作场所提供无创和负担得起的诊断信息。

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.