[1]范田依 王艳蕾 王守业 宋鹏杰.ROC曲线评估高频超声与肌电图诊断上肢神经卡压征的价值[J].卒中与神经疾病杂志,2019,26(03):307-312.[doi:10.3969/j.issn.1007-0478.2019.03.012]
　Fan Tianyi,Wang Yanlei,Wang Shouye,et al.Evaluation values of high frequency ultrasound and electromyography in diagnosis of upper limb nerve compression syndrome by ROC curve[J].Stroke and Nervous Diseases,2019,26(03):307-312.[doi:10.3969/j.issn.1007-0478.2019.03.012]
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ROC曲线评估高频超声与肌电图诊断上肢神经卡压征的价值()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第26卷
期数:
2019年03期
页码:
307-312
栏目:
论 著
出版日期:
2019-06-25

文章信息/Info

Title:
Evaluation values of high frequency ultrasound and electromyography in diagnosis of upper limb nerve compression syndrome by ROC curve
文章编号:
1007-0478(2019)03-0307-06
作者:
范田依 王艳蕾 王守业 宋鹏杰
066000 河北省秦皇岛军工医院超声科[范田依 王艳蕾(通信作者)王守业]; 河北省山海关人民医院超声科(宋鹏杰)
Author(s):
Fan Tianyi;  Wang Yanlei;  Wang Shouye;  et al
Department of Ultrasound, Qinhuangdao Military Hospital, Qinhuangdao Hebei 066000
关键词:
高频超声 肌电图 上肢神经卡压征 诊断价值
Keywords:
High-frequency ultrasound Electromyography Upper limb nerve compression syndrome Diagnostic value
分类号:
R745
DOI:
10.3969/j.issn.1007-0478.2019.03.012
文献标志码:
A
摘要:
目的 探讨ROC曲线对高频超声和肌电图检查在上肢神经卡压征中的诊断价值。方法 选取本院2016年3月-2018年2月收治的97例上肢神经卡压征患者为研究对象,均经过高频超声和肌电图检查并经手术确诊,同时另取30例健康志愿者为对照组; 采用高频超声检查肘管尺神经、腕管正中神经入口前后径、左右径及横截面积(CSA),采用受试者工作特征(receiver operating characteristic,ROC)曲线评估高频超声对上肢神经卡压征的诊断价值,采用四线格分析肌电图及联合检查对上肢神经卡压征的诊断价值。结果 肘管综合征患者尺神经入口处前后径、左右径及CSA均显著高于对照组(P<0.05),卡压处神经变细变弯,出现肿胀,神经纤维束回声消失,CSA诊断肘管综合征的AUC为0.851,最佳截点为9.25 mm2,灵敏度为90.1%,特异度为83.3%; 肌电图检查诊断肘管综合征的灵敏度为88.88%,特异度为80.00%,准确度为87.27%。腕管综合征患者卡压处神经炎性肿胀,内部回声不均匀,正中神经卡压处弯曲,周围组织结构发生改变,正中神经入口处前后径、左右径及CSA均显著高于对照组(P<0.05),CSA诊断腕管综合征的AUC为0.885,最佳截点为10.24 mm2,灵敏度为90.80%,特异度为80.00%; 肌电图检查诊断腕管综合征的灵敏度为89.58%,特异度为78.57%,准确度为87.09%。联合检测诊断肘管综合征灵敏度为93.33%,特异度为90.00%,准确度为92.73%; 诊断腕管综合征灵敏度为93.75%,特异度为85.71%,准确度为91.94%。结论 高频超声联合肌电图检查对上肢神经卡压征具有较高的诊断价值。
Abstract:
ObjectiveTo study the diagnostic values of high-frequency ultrasonography and electromyography in upper limb nerve compression syndrome by ROC curve.Methods 97 patients with upper limb nerve compression syndrome who were admitted to our hospital from March 2016 to February 2018 were selected as the research subjects, all of them underwent high-frequency ultrasonography and electromyography examination and were confirmed by surgery, meanwhile 30 healthy volunteers were selected as control group. The anteroposterior diameter, left and right diameter and cross-sectional area(CSA)in ulnar nerve of cubital tunnel and median nerve entrance of carpal tunne were examined by high-frequency ultrasound, the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of high-frequency ultrasound in upper limb nerve compression syndrome, the diagnostic values of electromyography and combined examination in upper limb nerve compression syndrome were analyzed by four line lattice.Results The anteroposterior diameter, left and right diameter and CSA of ulnar nerve entrance in patients with cubital tunnel syndrome were significantly higher than those in the control group(P<0.05), at the compression point the nerve became thinner, curved, swollen, and the echo of the nerve fiber bundle disappeared, the ACU of CSA in the diagnosis of carpal tunnel syndrome was 0.851, the best truncated value was 9.25 mm2, the sensitivity was 90.1%, and the specificity was 83.3%, the sensitivity, specificity and accuracy of electromyography in the diagnosis of cubital tunnel syndrome were 88.88%, 80.00% and 87.27% respectively. At the compression point of the patients with carpal tunnel syndrome the never was inammatory swelling, the internal echo was uneven, the nervi medianus compression point was curved, and the surrounding tissue structure changed, the anteroposterior diameter, left and right diameter and CSA of nervi medianus were significantly higher than those in the control group(P<0.05), The ACU of CSA in the diagnosis of carpal tunnel syndrome was 0.885, the best truncated value was 10.24 mm2, the sensitivity was 90.80%, and the specificity was 80.00%, the sensitivity, specificity and accuracy of electromyography in the diagnosis of carpal tunnel syndrome were 89.58%, 78.57% and 87.09% respectively. The sensitivity, specificity and accuracy of combined detection in the diagnosis of cubital tunnel syndrome were 93.33%, 90% and 92.73% respectively, the sensitivity, specificity and accuracy in the diagnosis of carpal tunnel syndrome were 93.75%, 85.71% and 91.94% respectively.Conclusion High-frequency ultrasound combined with electromyography was of high diagnostic value for upper limb nerve compression syndrome.

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更新日期/Last Update: 2019-06-25