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目的通过受试者工作特征曲线(ROC)比较高频超声、磁共振扩散加权神经成像技术(DW-MRN)对腕管综合征(CTS)的诊断价值。方法选取2014年2月至2015年8月CTS患者14例(17只手腕,CTS组)和健康志愿者13例(正常对照组,19只手腕)。两组行DW-MRN扫描,由2位阅片者独立测量腕管内豌豆骨水平正中神经的表观扩散系数(ADC),并同时行高频超声测量横截面积(CSA)。采用Student t检验检测CTS组和正常对照组腕管内正中神经CSA和ADC值的差异,并进行ROC分析。结果 CTS组与正常对照组腕管内正中神经CSA和ADC值差异有统计学意义(P均<0.001)。CTS组CSA的ROC曲线下面积较ADC值高(AUC>0.8),两者诊断效能差异无统计学意义(P>0.05)。结论 DW-MRN对CTS具有较好的诊断效能,与目前临床公认的高频超声诊断效能相当。
Objective To compare the diagnostic value of high-frequency ultrasound and DW-MRN in the diagnosis of carpal tunnel syndrome (CTS) through receiver operating characteristic curve (ROC). Methods From February 2014 to August 2015, 14 patients (17 wrists, CTS group) and 13 healthy volunteers (normal control group, 19 wrists) were selected. DW-MRN scanning was performed in two groups. Apparent diffusion coefficient (ADC) of mid-peal-level median nerve in carpal tunnel was measured independently by two readers and the cross-sectional area (CSA) was measured simultaneously by high-frequency ultrasound. Student’s t test was used to detect the difference of CSA and ADC value between the CTS group and the normal control group. The ROC analysis was performed. Results The CSA and ADC values of median nerve in carpal tunnel between CTS group and normal control group were significantly different (all P <0.001). The area under the ROC curve of CSA in CTS group was higher than ADC value (AUC> 0.8), and there was no significant difference in the diagnostic efficacy between the two groups (P> 0.05). Conclusion DW-MRN has good diagnostic efficacy for CTS, which is equivalent to the currently recognized high-frequency ultrasound diagnosis.