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目的探讨声触诊组织成像定量技术(virtual touch tissue imaging quantification,VTIQ)在腕管综合征(carpal tunnel syndrome,CTS)正中神经卡压诊断中的价值。方法CTS患者49例(72腕)为CTS组,健康志愿者23例(46腕)为对照组,均行二维超声检查测量腕管入口处正中神经横截面积(cross-sectional area,CSA),并应用VTIQ技术测量正中神经的剪切波速度(shear wave velocity,SWV);绘制ROC曲线计算正中神经CSA及SWV诊断CTS的效能。结果 CTS组正中神经CSA[(0.131±0.041)cm2]较对照组[(0.073±0.019)cm2]大,SWV[(3.857±1.029)m/s]较对照组[(2.542±0.368)m/s]快(P<0.05);正中神经CSA诊断CTS最佳截断值为0.095cm2,AUC为0.894(95%CI:0.839~0.949,P=0.001),灵敏度、特异度和准确度分别为76.4%、89.1%和81.4%;正中神经SWV诊断CTS最佳截断值为3.020m/s,AUC为0.930(95%CI:0.886~0.975,P=0.001),灵敏度、特异度和准确率分别为83.3%、91.3%和86.4%。结论应用VTIQ技术检测腕管入口处正中神经SWV值和应用二维超声测量腕管入口处正中神经CSA,在CTS诊断中均具有较好的应用价值。
Objective To investigate the value of virtual touch tissue imaging quantification (VTIQ) in the diagnosis of median nerve compression in carpal tunnel syndrome (CTS). Methods 49 cases (72 wrists) of CTS were CTS group and 23 healthy volunteers (46 wrists) were used as control group. The cross-sectional area (CSA) of carpal tunnel was measured by two-dimensional ultrasonography. The shear wave velocity (SWV) of the median nerve was measured by VTIQ technique. The ROC curve was drawn to calculate the efficacy of the median nerve CSA and SWV in the diagnosis of CTS. Results Compared with the control group [(2.542 ± 0.368) m / s], the CSA of the median nerve in the CTS group was (0.131 ± 0.041) cm 2 higher than that in the control group (0.073 ± 0.019 cm 2 vs SWV [(3.857 ± 1.029) m / (P <0.05). The best cutoff value of CTS was 0.095cm2 and the AUC was 0.894 (95% CI: 0.839-0.949, P = 0.001). The sensitivity, specificity and accuracy were 76.4% 89.1%, and 81.4% respectively. The best CTS value of median nerve was 3.020m / s, AUC was 0.930 (95% CI: 0.886-0.975, P = 0.001) .The sensitivity, specificity and accuracy were 83.3% 91.3% and 86.4%. Conclusions The application of VTIQ to detect median nerve SWV at the entrance of carpal tunnel and the application of two-dimensional ultrasound to measure median nerve CSA at the entrance of carpal tunnel all have good value in the diagnosis of CTS.