摘要
目的采用高频超声量化分析不对称性神经病理性疼痛的周围神经损伤,建立超声下神经损伤的评分方法(DCEC)及其阈值。资料与方法收集40例不对称性神经病理性疼痛患者,分析其神经传导及周围神经超声检查结果,对疼痛侧和对侧肢体每条神经在超声下的神经清晰度、最大横截面积、回声和卡压进行评分,计算单个肢体3条神经的总评分,并确定其诊断价值和界限值。结果 40例不对称性神经病理性疼痛患者疼痛侧单个肢体超声评分高于对侧,差异有统计学意义(P<0.01);神经传导异常组患者疼痛侧及对侧肢体超声总评分[(5.88±3.14)分、(4.75±2.74)分]均大于神经传导正常组[(3.31±1.78)分、(2.94±2.14)分],差异有统计学意义(P<0.05);疼痛侧和对侧肢体超声评分异常的临界值分别为5.5分和2.5分时约登指数最大,其敏感度分别为60.9%和88.2%,特异度分别为88.2%和60.9%。结论 DCEC评分对于不对称性神经损伤程度有一定的检测意义,并确定了不对称性神经病理性疼痛患者疼痛侧和对侧单个肢体周围神经损伤的超声评分界限值。
Purpose To quantitatively analyze peripheral nerve injury of asymmetric neuropathic pain by high-frequency ultrasound, and to establish the scoring method definition, cross sectional area, echogenicity and compression (DCEC) and its threshold value of nerve injury under ultrasound. Materials and Methods A total of 40 patients with asymmetric neuropathic pain were collected. The results of neurotransmission and peripheral nerve ultrasound examination were analyzed. The nervous sharpness, maximum cross-sectional area, echo and nerve entrapment under ultrasound of each nerve on the pain side and contralateral limb were scored, and the total scores of the three nerves of a single limb were calculated to determine the diagnostic and threshold value. Results Among 40 patients with asymmetric neuropathic pain, the ultrasound score of a single limb on the pain side was higher than that on the contralateral side, the difference of which was statistically significant (P<0.01);The total ultrasound scores [(5.88±3.14) points,(4.75±2.74) points] of the pain side and contralateral limb in the group with abnormal nerve conduction were both higher than that in the group with normal nerve conduction [(3.31±1.78) points,(2.94±2.14) points], the difference of which was statistically significant (P<0.05);the Youden index maximized when the critical value for abnormal ultrasound score of the pain side and contralateral limbs reached 5.5 points and 2.5 points respectively, corresponding to sensitivity of 60.9% and 88.2%, specificity of 88.2% and 60.9%. Conclusion The DCEC scoring features certain significance for detection of severity of asymmetric nerve injury, and the threshold value for ultrasound scoring of peripheral nerve injury in the pain side and contralateral single limb of patients with asymmetric neuropathic pain is determined.
作者
吴香花
欧阳倩
罗芳
吴珊
WU Xianghua;OUYANG Qian;LUO Fang;WU Shan(Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2019年第4期292-297,共6页
Chinese Journal of Medical Imaging
基金
贵州省科技合作计划(黔科合计LH字[2015]7407号)
关键词
神经痛
超声检查
周围神经
神经损伤
参考值
敏感性与特异性
Neuralgia
Ultrasonography
Peripheral nerves
Nerve injuries
Reference values
Sensitivity and specificity
