medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2026-6-21-27medalphabet-4938Research ArticleСтатьиСравнительный анализ результатов ультразвукового и электрофизиологического исследований при легкой степени невропатии локтевого нерва на уровне локтяComparative analysis of ultrasound and electrophysiological studies in mild ulnar neuropathy at the elbowhttps://orcid.org/0000-0002-7345-2388ФадееваЮ. В.FadeevaY. V.

Фадеева Юлия Викторовна – к.м.н, доцент кафедры клинической физиологии  и функциональной диагностики, врач функциональной диагностики

Москва

Fadeeva Yulia V. – Ph.D., Associate Professor of the Department of Clinical Physiology and Functional Diagnostics

jvdav@mail.ruhttps://orcid.org/0000-0001-6087-6918ТимонинА. Н.TimoninA. N.

Тимонин Андрей Николаевич – к.б.н., научный сотрудник лаборатории иммунологии, высококвалифицированный научный сотрудник

Москва

Timonin Andrey N. – Ph.D., Researcher of the Laboratory of Immunology

andrey8407@mail.ruhttps://orcid.org/0000-0001-7071-3741НосенкоН. С.NosenkoN. S.

Носенко Наталья Сергеевна – к.м.н., доцент кафедры рентгенологии  и ультразвуковой диагностики, руководитель центра ультразвуковых  и функциональных методов исследования

Москва

Nosenko Natalia. S. – Ph.D., Associate Professor of the Department of Radiology  and Ultrasound Diagnostics, Head of the Department of Functional and Ultrasound Diagnostics

nataly1679@gmail.comhttps://orcid.org/0000-0001-5026-0060СинкинМ. В.SinkinM. V.

Синкин Михаил Владимирович – д.м.н., доцент, ведущий научный сотрудник отделения неотложной нейрохирургии

Москва

Sinkin Mikhail V. – Dr. Sci. (Med.), Head, Clinical neurophysiology laboratory, Emergency neurosurgery department

sinkinmv@sklif.mos.ruФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий ФМБА России»РоссияFederal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency, Department of Clinical Physiology and Functional Diagnostics of the Academy of Postgraduate EducationRussian FederationФГБУН «ФИЦ питания и биотехнологии»; Физический институт РАН (ФИАН)РоссияFederal Research Centre of Nutrition, Biotechnology and Food Safety; Lebedev Physical InstituteRussian FederationГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского ДЗМ»ГБУЗРоссияN.V. Sklifosovsky Research Institute for Emergency MedicineRussian Federation20261304202606Современная функциональная диагностика (1)2127Copyright © Фадеева Ю.В., Тимонин А.Н., Носенко Н.С., Синкин М.В., 20262026Фадеева Ю.В., Тимонин А.Н., Носенко Н.С., Синкин М.В.Fadeeva Y.V., Timonin A.N., Nosenko N.S., Sinkin M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/4938

Введение. Электрофизиологическое исследование является основной составляющей инструментальной диагностики невропатии локтевого нерва на уровне локтя (НЛНЛ). В последние годы возрастающее значение приобретает ультразвуковое исследование нервов с возможностью определения области компрессии, динамического исследования и оценки окружающих нерв структур. Цель исследования. Сравнить результаты электронейромиографии (ЭНМГ) и УЗИ у пациентов с клиническими признаками НЛНЛ. Материалы и методы. Проанализированы данные ЭНМГ и УЗИ локтевого нерва у 93 пациентов с клиническими признаками НЛНЛ легкой (86 человек) и средней (7 человек) степени тяжести по МакГоуэн. Проведено исследование сенсорного и моторного проведения по локтевому нерву с двух сторон, УЗИ локтевого нерва на всем протяжении с оценкой площади поперечного сечения (ППС) и динамическое исследование на предмет нестабильности. Результаты. Электрофизиологические изменения, соответствующие НЛНЛ, выявлены у 48 (51,5%) обследован ных пациентов, ультразвуковые изменения у 50 (54%). Группы с положительным и отрицательными результатами ЭНМГ и УЗИ не отличались по основным антропометрическим характеристикам пациентов и продолжительности заболевания. При поражении локтевого нерва слева результаты ЭНМГ и УЗИ чаще положительны; наличие m. anconeus epitrochlearis в позадинадмыщелковой борозде чаще сопровождается отрицательными результатами ЭНМГ. Для ППС локтевого нерва характерна обратная корреляционная связь с амплитудой сенсорного ответа локтевого нерва, СРВм на уровне локтевого сустава и амплитудой М-волны с мышцы, отводящей мизинец. Максимальная ППС локтевого нерва на уровне локтевого сустава отличается у пациентов с различной тяжестью НЛНЛ (p = 0,0001). Выводы. В исследуемой группе, характеризовавшейся преобладанием пациентов с легкой степенью тяжести синдрома кубитального канала, результаты ЭНМГ и УЗИ обладают значительной согласованностью. Выявленные межфакторные взаимодействия указывают на необходимость комплексного подхода к диагностике поражений локтевого нерва с учетом латерализации процесса и особенностей анатомии.

Introduction. Nerve conduction study (NCS) is the main component of instrumental diagnostics of ulnar neuropathy at the elbow (UNE). In recent years, ultrasound (US) examination has become increasingly important, allowing the identification of the site of compression, dynamic examination, and assessment of the structures surrounding the nerve. Aim. To compare the results of NCS and US in patients with clinical signs of UNE. Materials and methods. The NCS and US data were analyzed in 93 patients with clinical signs of mild (86 patients) and moderate (7 patients) UNE. Standard NCS studies and US of the ulnar nerve were analyzed. Results. Electrophysiological changes corresponding to UNE were detected in 48 (51.5%) examined patients, ultrasound changes in 50 (54%). The groups with positive and negative NCS and US results did not differ in the main anthropometric characteristics and disease duration. When the left ulnar nerve is involved, nerve conduction study and ultrasoun are often positive; the presence of m. anconeus epitrochlearis in the retroepicondylar groove is often accompanied by negative nerve conduction study results. The ulnar nerve CSA is characterized by an inverse correlation with the amplitude of the ulnar nerve sensory response, motor nerve conduction velocity at the elbow and compound muscle action potential amplitude recorded from abductor digiti minimi muscle. The maximum ulnar nerve CSA at the elbow differs in patients with different UNE severity (p = 0.0001). Conclusions. In the group of patients, which was characterized by a predominance of patients with mild cubital tunnel syndrome, NCS and ultrasound results are highly consistent. The identified factorial interactions indicate the need for a comprehensive approach to diagnosing ulnar nerve lesions, taking into account the lateralization of the process and the specific anatomical features.

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