剪切波弹性成像在腕管综合征诊断中的应用研究进展

Application and Research Progress of Shear Wave Elastography in the Diagnosis of Carpal Tunnel Syndrome

摘要: 腕管综合征(CTS)是临床最常见的周围神经卡压性疾病。传统诊断依赖临床症状与神经电生理检查，存在有创性、假阴性率高及无法评估神经生物力学特性等局限。剪切波弹性成像(SWE)能够无创、客观地量化正中神经硬度，为CTS的早期诊断、严重程度分级及疗效监测提供了新的影像学手段。本文系统回顾SWE在CTS中的应用研究进展：现有证据表明，SWE具有良好的诊断效能，正中神经硬度与电生理严重程度呈正相关，且SWE在早期诊断中具有独特优势；多指标联合可提升诊断准确性。该技术仍受限于操作者依赖性、受试者个体差异及设备间差异等，建立标准化操作流程是SWE临床转化的关键前提。未来黏弹性成像、三维SWE及人工智能辅助分析等技术的发展将拓展其应用前景。

Abstract: Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy in clinical practice. Conventional diagnostic approaches rely on clinical symptoms and nerve conduction studies, which are invasive, have a high false-negative rate, and fail to evaluate the biomechanical properties of nerves. Shear wave elastography (SWE), as a non-invasive and objective quantitative technique for assessing median nerve stiffness, provides a novel imaging modality for early diagnosis, severity grading, and therapeutic monitoring of CTS. This article systematically reviews the research progress of SWE in CTS applications. Current evidence demonstrates that SWE has favorable diagnostic efficacy; median nerve stiffness is positively correlated with electrophysiological severity, and SWE exhibits a unique advantage in early diagnosis. The combination of multiple parameters can further improve diagnostic accuracy. However, this technique remains limited by operator dependence, subject-related variability, and inter-equipment variability. Establishing standardized scanning protocols is a critical prerequisite for the clinical translation of SWE. Future advances in viscoelastic imaging, three-dimensional SWE, and artificial intelligence-assisted analysis are expected to expand its clinical application.