zdorПроблемы здоровья и экологииHealth and Ecology Issues2220-09672708-6011Gomel State Medical University10.51523/2708-6011.2024-21-4-05zdor-2751Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEУльтразвуковая эластография: возможности ранней диагностики мононевропатии седалищного нерваUltrasound elastography: possibilities for early diagnosing in case of sciatic nerve mononeuropathyhttps://orcid.org/0000-0002-7496-545XПисьменниковаЕ. И.PismennikovaE. I.

Evgenia I. Pismennikova, Senior Lecturer at the Department of Radiation Diagnostics with the course of Advanced Training and Retraining

Gomel

pismennikova.gsmu@gmail.comhttps://orcid.org/0000-0003-0808-183XЮрковскийА. М.YurkovskiyА. М.

Юрковский Алексей Михайлович, д.м.н., заведующий кафедрой лучевой диагностики с курсом ФПКиП

г. Гомель

Аlexei М. Yurkovskiy, Doctor of Medical Sciences, Head of the Department of Radiation Diagnostics with the course of Advanced Training and Retraining

Gomel

yurkovsky@mail.ruБобовичН. В.BobovichN. V.

Бобович Наталья Вячеславовна, врач лучевой диагностики

г. Гомель

Natalia V. Bobovich, Radiologist

Gomel

n_bobo@mail.ruЛихачевскаяМ. А.LikhachevskayaM. А.

Лихачевская Мария Александровна, ассистент кафедры лучевой диагностики с курсом ФПКиП

г. Гомель

Maria А. Likhachevskaya, Assistant Lecturer at the Department of Radiation Diagnostics with the course of Advanced Training and Retraining

Gomel

lissmaria@yandex.ruГомельский государственный медицинский университетGomel State Medical UniversityГомельский областной клинический онкологический диспансерGomel Regional Clinical Oncologic Dispensary2024160120252144552Copyright © Письменникова Е.И., Юрковский А.М., Бобович Н.В., Лихачевская М.А., 20252025Письменникова Е.И., Юрковский А.М., Бобович Н.В., Лихачевская М.А.Pismennikova E.I., Yurkovskiy А.М., Bobovich N.V., Likhachevskaya M.А.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.gsmu.by/jour/article/view/2751Цель исследования

Цель исследования. Оценить возможность применения ультразвуковой эластографии для выявления ранних проявлений мононевропатии седалищного нерва (МНСН).

Материалы и методы

Материалы и методы. Для достижения поставленной цели было проведено сопоставление данных ультразвуковой эластографии седалищного нерва 30 пациентов в возрасте 46,0 (23; 54) лет с клиническими проявлениями МНСН (опытная группа) и 30 пациентов в возрасте 36,5 (29; 48) года без боли внизу спины (группа контроля).

Результаты

Результаты. Результаты оценки диагностической значимости ультразвуковой эластографии в качестве метода диагностики МНСН были следующими (при асимметрии между индексами жесткости сопоставимых сегментов симптоматической и бессимптомной сторон более 22 %): AUC — 0,88 (95 % ДИ (0,55; 0,99)), р = 0,003; индекс Юдена — 0,87, чувствительность — 87 % (95 % ДИ (0,5; 0,99)), р = 0,0001; специфичность — 100 % (95 % ДИ (0,5; 0,99)), р = 0,0001.

Заключение

Заключение. Ультразвуковая эластография позволяет выявлять изменения структуры седалищного нерва в случаях, когда стандартное исследование проводится в В-режиме и не выявляет изменений. Наличие клинических признаков, предполагающих МНСН, при отсутствии структурных изменений в В-режиме следует считать основанием для проведения ультразвуковой эластографии с целью выявления периневрального и интраневрального отека, а также структурных изменений седалищного нерва.

Objective

Objective. To evaluate the possibility of using ultrasound elastography to detect early manifestations of sciatic nerve mononeuropathy.

Materials and methods

Materials and methods. A comparison of ultrasound elastography data of the sciatic nerve of 30 patients aged 46.0 (23; 54) years with clinical manifestations of sciatic nerve mononeuropathy (experimental group) and 30 patients aged 36.5 (29; 48) years without lower back pain back (control group) was made to achieve this goal.

Results

Results. Assessment results of the diagnostic utility of ultrasound elastography as a method for diagnosing mononeuropathy of the sciatic nerve were as follows (with an asymmetry between the stiffness indices of comparable segments of the symptomatic and asymptomatic sides of more than 22%): AUC - 0,88 (95% CI (0,55; 0,99)), р=0,003; Youden index - 0.87, sensitivity - 87% (95% CI (0,5; 0,99)), р=0,0001; 100% (95% CI (0,5; 0,99)), р=0,0001.

Conclusion

Conclusion. Ultrasound elastography makes it possible to detect changes in the structure of the sciatic nerve in cases where a standard B-mode study does not reveal changes. The presence of clinical signs suggesting mononeuropathy of the sciatic nerve, in the absence of structural changes in the B-mode, should be considered the basis for performing ultrasound elastography in order to detect perineural and intraneural edema, as well as structural changes in the sciatic nerve.

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The authors declare that there are no conflicts of interest present.