【摘要】 目的:分析臂丛神经下干受压型胸廓出口综合征的超声声像图特征,探讨超声在诊断此类疾病中的价值。方法:回顾分析2012年5月至2020年5月之间于我院进行超声诊断并经手术证实为臂丛神经下干受压型胸廓出口综合征的23例患者。检查仪器为PHILIPS EPIQ5及iU22彩色多普勒超声诊断仪。以术中所见为金标准,归纳臂丛神经下干受压型胸廓出口综合征的超声声像图特征,分析超声诊断此类疾病的直接征象与间接征象。结果:臂丛神经下干受压型胸廓出口综合征超声声像图的直接征象为:颈8与胸1神经根或/与下干受压,19例,阳性率为82.6%。间接征象为:(1)锁骨下动脉上抬,18例,阳性率为78.3%;(2)异常突起的骨性结构,9例,阳性率为39.1%;(3)颈8或胸1神经根或/与下干增粗,且均未见直接受压征象,3例,阳性率为13.0%。结论:超声观察到颈8与胸1神经根或/与下干受压的直接征象对诊断臂丛神经下干受压型胸廓出口综合征具有较强的提示作用。间接征象如锁骨下动脉上抬、异常突起的骨性结构、颈8或胸1神经根或/与下干增粗有助于此类疾病的超声诊断。更多还原

【Abstract】 Purpose: To analyze the ultrasonographic features of neurogenic thoracic outlet syndrome with compression of the lower brachial plexus. And to explore the value of ultrasonography in the diagnosis of it.Methods: Twenty-three patients were included in this retrospective study, who were diagnosed neurogenic thoracic outlet syndrome with compression of the lower brachial plexus by ultrasonography in department of medical ultrasound in our hospital and confirmed by surgery in department of hand surgery in our hospital between May 2012 and May 2020. PHILIPS EPIQ5 and iU22 were used as color Doppler ultrasound diagnostic equipment. With intraoperative findings used as the golden standard, the ultrasonographic features of neurogenic thoracic outlet syndrome with compression of the lower brachial plexus were summarized. The direct and indirect signs of the disease were analyzed. Results: The direct signs of ultrasonography of neurogenic thoracic outlet syndrome with compression of the lower brachial plexus were: compressed C8 and T1 nerve roots with or without compression of the inferior trunk, 19 cases, with a positive rate of 82.6%. The indirect signs were:(1) elevation of the subclavian artery, 18 cases, with a positive rate of 78.3%;(2)abnormally protruding bony structures, 9 cases, with a positive rate of 39.1%;(3) thickened C8 or T1 nerve root with or without thickened inferior trunk, with no signs of direct compression, 3 cases, with a positive rate of 13.0%. Conclusion: The direct signs of compressed C8 and T1 nerve roots with or without compression of the inferior trunk are strong predictive signs in the ultrasonographic diagnosis of neurogenic thoracic outlet syndrome with compression of the lower brachial plexus. Indirect signs such as elevation of the subclavian artery, abnormally protruding bony structures, thickened C8 or T1 nerve root with or without thickened inferior trunk can help to diagnose this disease by ultrasonography.更多还原