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

描述(申请人提供)：使用医学超声成像正中神经，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创新的非侵入性替代方案。进一步探索利用超声波作为健康监测工具来监测CTS高危职业工人正中神经的健康状况的潜力也是创新的。因此，这项建议的中心假设是，使用高频探头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。这将使用意志力动物模型进行探索，以确定使用多普勒、灰阶成像和综合检查(EDX、MRI和超声波)是否可以跟踪正中神经从基线到结束暴露直至恢复的病理变化。能量多普勒能够记录神经周围小动脉充血和血流增加等急性变化。灰阶多普勒能够记录与正中神经病变(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是很难在工作场所进行的测试，但它们被认为是临床标准，重要的是将8只猕猴的超声数据与这些测量结果进行对比，这些猕猴的MMN正在从基线走向恢复。该项目将有助于加快超声波的使用，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：这项实验的翻译影响将是验证超声是一种非侵入性成像技术，用于监测由于手腕重复任务而进展的MMN。之前的工作因人类受试者参与工作场所以外的贡献活动而有所减轻。这项研究将评估MMN的进展和使用便携式超声作为追踪正中神经病理的动态和敏感手段的效用。

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.