超声剪切波弹性成像联合高频多普勒超声对老年腕管综合征的诊断价值分析

Analysis of value of ultrasound shear wave elastography combined with high-frequency Doppler ultrasound in diagnosis of carpal tunnel syndrome in the elderly

中文关键词: 老年  腕管综合征  超声检查  剪切波弹性成像  高频多普勒超声  严重程度  诊断价值

英文关键词: elderly  carpal tunnel syndrome  ultrasound examination  shear wave elastography  high-frequency Doppler ultrasound  severity  diagnostic value

中文摘要:

      目的 分析超声剪切波弹性成像(SWE)与高频多普勒超声(HDU)对老年腕管综合征(CTS)的诊断价值.方法 回顾性收集遂宁市第一人民医院收治的131例老年CTS患者的临床资料,分为轻度组(n=29)、中度组(n=78)、重度组(n=24),纳入同期50例无CTS志愿者为对照组.比较4组SWE参数[横切测值(Eentrance、Einner、Eexport、Eforearm和Fratio)]、HDU参数[横截面积(CSA)、横截面积变化量(△-CSA)和横截面积比率(R-CSA)],行方差分析和LSD-t检验.采用Logistic多因素回归分析影响老年CTS严重程度的独立危险因素.绘制受试者工作特征(ROC)曲线,以曲线下面积(AUC)评价SWE、HDU参数对老年重度CTS的诊断价值.结果 与对照组比较,CTS患者Eentrance、Einner、Eexport、Eforearm、Fratio、CSA、△-CSA和R-CSA值均升高,且随严重程度增加而升高,差异均有统计学意义(P＜0.05).Logistic回归分析结果显示,CSA、Eexport和Fratio为影响CTS严重程度的独立危险因素(P＜0.05).ROC曲线分析结果显示,CSA、Eexport和Fratio诊断重度CTS的AUC分别为0.887、0.852和0.748,联合因子(并联)的AUC为0.957(95％CI:0.906～0.985),敏感度为83.33％,特异度为94.39％,联合因子AUC高于单独指标(Z=2.930、3.377、3.528,P＜0.05).结论 SWE、HDU参数与老年CTS病情严重程度密切相关,CS△、Eexport和Fratio可作为老年CTS的诊断指标,联合检测有助于提高诊断准确性.

英文摘要:

      Objective To analyze the value of shear wave elastography(SWE)and high-frequency Doppler ultrasound(HDU)in diagnosis of carpal tunnel syndrome(CTS)in the elderly.Methods The clinical data of 131 elderly CTS patients admitted to First People's Hospital of Suining City were retrospectively collected and divided into mild group(n=29),moder-ate group(n=78)and severe group(n=24).Fifty volunteers without CTS during the same period were included as the con-trol group.The SWE parameters[transverse slice measurements(Eentrance,Einner,Eexport,Eforearm and Fratio)]and HDU parameters[cross-sectional area(CSA),cross-sectional area change(△-CSA)and cross-sectional area ratio(R-CSA)]were compared among the four groups.The analysis of variance and LSD-t tests were performed.Multivariate Logistic regres-sion analysis was used to identify independent risk factors influencing the severity of CTS in the elderly.Receiver operating characteristic(ROC)curves were plotted,and the area under the curve(AUC)was used to evaluate the diagnostic value of SWE and HDU parameters for severe CTS in the elderly.Results The values of Eentrance,Einner,Eexport,Eforearm,Fratio,CSA,△-CSA and R-CSA in CTS patients all increased,and they increased with the increase of severity.The differ-ences were statistically significant(P＜0.05).Logistic regression analysis showed that CSA,Eexport and Fratio were inde-pendent risk factors influencing the severity of CTS(P＜0.05).ROC curve analysis results showed that the AUCs of CSA,Eexport and Fratio in diagnosing severe CTS were 0.887,0.852 and 0.748,respectively.The AUC of the combination(paral-lel)of the three indexes was 0.957(95％CI:0.906-0.985),with a sensitivity of 83.33％and a specificity of 94.39％.The AUC of combined diagnosis was greater than that of each indicator(Z=2.930,3.377,3.528,P＜0.05).Conclusion The parameters of SWE and HDU are closely related to the severity of CTS in elderly patients.CSA,Eexport and Fratio can be used as diagnostic indicators of CTS in elderly patients,and the combined detection is helpful to improve the diagnostic accuracy.