由于阴险的性格和症状的变化,Charcot-Marie-Tooth(CMT)疾病对儿童的诊断具有挑战性。诊断基于临床和神经传导研究,以及基因检查。因此,有能力的神经成像技术和非侵入性替代神经传导研究是必要的,尤其是儿童。我们进行了系统评价和荟萃分析,以评估超声在研究CMT患者与健康对照组相比的神经横截面积(CSA)方面的当前证据和有效性,并汇集CSA测量值。我们纳入了发表在国际同行评审期刊上的研究,这些研究通过超声测量CMT患者的神经CSA。我们实施了双臂荟萃分析,通过计算CSA的合并平均差,比较了CMT患者和健康对照组之间神经的平均CSA。此外,我们根据CSA测量部位对研究进行了分组分析,并检查了CMT1A和其他CMT类型在神经CSA方面的差异.纳入的研究提供了12个神经根和神经(迷走神经,C3,C4,C5,C6,大耳廓,膈,中位数,尺骨,腓骨,胫骨和腓肠神经)在628例CMT患者和586例健康对照中,总共测量了6061条神经。提供了超声神经CSA的荟萃分析,以表达神经超声在CMT患者诊断中的价值。
Because of the insidious character and variations in presenting symptoms, Charcot-Marie-Tooth (CMT) disease is challenging to diagnose in children. Diagnosis is based on clinical and nerve conduction studies, as well as genetic examination. Therefore, competent nerve imaging techniques and non-invasive alternatives to nerve conduction studies are a necessity, especially in children. We performed a systematic
review and meta-analysis to evaluate the current evidence and effectiveness of ultrasound in investigating nerve cross-sectional area (CSA) in those with CMT compared with healthy controls and to pool the CSA measurements. We included studies published in international peer-reviewed journals that measured nerve CSA by ultrasound in patients with CMT. We implemented double-arm meta-analyses to compare the mean CSA of nerves between patients with CMT and healthy controls by calculating the pooled mean difference in CSA. Moreover, we performed subgroup analyses by stratifying the studies according to the site of CSA measurement and examined the difference in nerve CSA between CMT1A and other CMT types. The included studies provide measurements of 12 nerve roots and nerves (vagus, C3, C4, C5, C6, greater auricular, phrenic, median, ulnar, fibular, tibial and sural nerves) in 628 patients with CMT and 586 healthy controls with a total of 6061 measured nerves. Meta-analyses of sonographic nerve CSA are provided to express nerve ultrasonography in the diagnosis of CMT patient.