断层影像解剖

正常人腕管内正中神经的超声解剖学研究及其意义

  • 俞淼 ,
  • 朱学平 ,
  • 史增元 ,
  • 陈德松
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  • 1.宁波大学医学院附属医院创伤骨科;     2.宁波大学医学院附属医院超声影像科,  浙江 宁波 315020;
    3.复旦大学附属华山医院手外科, 上海  200040
俞淼(1981-),男,主治医师,硕士,研究方向:手外科学、周围神经超声影像学,Tel:13685826570

收稿日期: 2014-11-02

  网络出版日期: 2015-02-12

Ultrasonographic anatomy of median nerve in carpal tunnel of normal persons

  • SHU Miao ,
  • SHU Hua-Beng ,
  • SHI Ceng-Yuan ,
  • CHEN De-Song
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  • 1.Department of Orthopaedics, Affiliated Hospital of Medical Academy in Ningbo University, Ningbo 315020, Zhejiang, China; 2.Department of Ultrasonographic Image, Affiliated Hospital of Medical Academy in Ningbo University, Ningbo 315020, Zhejiang, China; 3.Department of Hand Surgery, Huashan Affiliated Hospital of Fudan University, Shanghai 20040, China

Received date: 2014-11-02

  Online published: 2015-02-12

摘要

目的 探讨腕管内正中神经的超声解剖测量方法及各项指标,为临床提供正常解剖参数。方法    应用高频超声检查60侧正常人腕管段正中神经,分别测量其腕管入口、中点和出口平面的横截面积,腕管中点平面正中神经的扁平率和屈肌支持带的厚度。应用超声剪切波弹性成像技术测量30侧腕管内正中神经近1/3段、中1/3段、远1/3段的硬度值。 结果   腕管入口、中点、出口平面正中神经截面积分别为(0.09±0.02)、(0.08±0.02)、(0.10±0.03)cm2,不同部位截面积均值无统计学差异(P<0.01);腕管中点平面正中神经的扁平率3.12±0.29;屈肌支持带厚度为(0.33±0.07)cm。正中神经腕管近段、中段、远段最高硬度的分别为(41.3±10.3)、(35.4±5.8)、(38.1±4.3)kPa,不同部位硬度均值无统计学差异(P>0.05)。 结论    高频超声检查为临床提供了腕管内正中神经形态学解剖参数,剪切波弹性成像提供了神经硬度参数。两者结合应用为腕管综合征的临床诊断提供超声解剖学依据。

本文引用格式

俞淼 , 朱学平 , 史增元 , 陈德松 . 正常人腕管内正中神经的超声解剖学研究及其意义[J]. 中国临床解剖学杂志, 2015 , 33(1) : 24 -27 . DOI: 10.13418/j.issn.1001-165x.2015

Abstract

Objective   To discuss measuring methods and indicators in ultrasonographic anatomy of the median nerve in carpal tunnel.  Methods   60 sides media nerve in carpal tunnel of normal subjects underwent high-frequency ultrasonographic examination. Cross-sectional area of the median nerve at entrance plane, midpoint plane and exit plane were measured.  thethickness of the palmar retinaculum, the flattening ratio of the median nerve at midpoint were measured too. The stiffness of median nerve in carpal tunnels of 30 sides was measured at the proximal 1/3 segment, middle 1/3 segment, and distal 1/3 segment by ultrasonic shear wave elastography. Results:The mean cross-sectional area of the median nerve at entrance plane, midpoint plane and exit plane respectively were(0.09±0.02)cm2,(0.08±0.02)cm2 and (0.10±0.03)cm2; There was no statistical difference among the mean value. The mean flattening ratio of the median nerve at midpoint plane was 3.12±0.29. The mean thickness of palmar retinaculum was(0.33±0.07)cm. The mean value of maximum stiffness at the proximal segment, the middle segment, and the distal segment respectively were (41.3±10.3)kPa,(35.4±5.8)kPa and(38.1±4.3)kPa,there was no statistical difference among the  mean value. Conclusion: High-frequency ultrasonographic examination may provide parameters of the median nerve in carpal tunnel, and shear wave elastography may provide stiffness parameter of the median nerve. Combined application of both examination may provide anatomical gist for clinical diagnosis of carpal tunnel syndrome.

参考文献


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