Ультразвуковое исследование срединного нерва при диагностике синдрома запястного канала

Наиболее распространенным среди туннельных синдромов является синдром запястного канала (СЗК), вызванный компрессией срединного нерва. В иллюстрированном обзоре литературы представлены методика ультразвукового исследования срединного нерва и ультразвуковая картина срединного нерва при синдроме запястного канала. Проведен анализ критериев ультразвуковой диагностики синдрома запястного канала. Среди рекомендованных для практики критериев выделены: площадь поперечного сечения срединного нерва на входе в запястный канал и (или) выходе из него ≥0,11 см² (11 мм²), при высоком делении нерва на два ствола - ≥0,12 см² (12 мм²); разница площади поперечного сечения срединного нерва на входе в запястный канал и (или) выходе из него и площади поперечного сечения срединного нерва на границе средней и нижней третей предплечья >0,02 см² (2 мм²) и (или) индекс увеличения площади поперечного сечения >1,93; изменение формы срединного нерва на продольных срезах по типу песочных часов с появлением участка компрессионной деформации под поперечной запястной связкой; снижение эхогенности и потеря пучковой дифференцировки срединного нерва на входе в запястный канал, в канале и (или) на выходе из канала; локальное усиление васкуляризации срединного нерва в зоне утолщения на запястье перед входом в запястный канал (только в сочетании с признаком значимого увеличения площади поперечного сечения срединного нерва).

ультразвуковая диагностика, срединный нерв, синдром запястного канала (карпальный туннельный синдром)

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