目的:高分辨率超声检查(US)可以在神经研究中发挥重要作用,因为它有几个优点。胫骨远端神经分支的压迫可以通过选择性麻醉阻滞来定位或诊断,美国可以指导治疗程序,如射频消融和特定神经分支的选择性浸润。这项研究的目的是验证US是精确定位胫骨后神经及其末端分支的有效方法。如内侧跟骨分支,第一个跟骨分支,足底内侧和外侧神经。
方法:在本研究中,我们分析了尸体解剖后US图与真实解剖之间的相关性,评估胫神经及其末端分支的分布和变异性。我们用了12个新鲜的足踝解剖标本,包括小牛.对胫神经及其分支进行了高分辨率的美国研究。
结果:美国对解剖标本的研究结果绘制为纸质图和数据收集表。每个解剖标本都完成了两次,首先使用US研究的结果,其次使用解剖标本的解剖结果;这种方法使我们能够比较结果,并验证US研究和解剖在胫神经及其末端分支的地形图上是否相关.我们发现美国和解剖结果几乎完全一致,评价之间没有显著差异。
结论:在这项工作的基础上,我们可以得出结论,高分辨率US作为识别胫神经及其分支的工具几乎100%有效,使专家能够对每个神经分支进行诊断或进行选择性治疗,甚至在进行解剖之前通过观察患者的解剖结构来设计手术干预措施。
OBJECTIVE: High-resolution ultrasonography (US) can play an important role in studying nerves, as it has several advantages. Entrapments of distal tibial nerve branches can be mapped out or diagnosed with selective anesthetic blocks, and US can guide therapeutic procedures, such as radiofrequency ablation and selective infiltrations of specific nerve branches. The aim of this study was to verify that US is an effective method for accurately locating the posterior tibial nerve and its terminal branches, such as the medial calcaneal branch, the first calcaneal branch, and the medial and lateral plantar nerves.
METHODS: In this study, we analyzed the correlation between US mapping and real anatomy after cadaveric dissection, assessing the distribution and variability of the tibial nerve and its terminal branches. We used 12 fresh anatomic specimens of the foot and ankle, including the calf. A high-resolution US study of the tibial nerve and its branches was performed.
RESULTS: The results of the US studies of the anatomic specimens were drawn as paper diagrams and in data collection tables. Both were completed twice per anatomic specimen, first using the results of the US study and second using the results from dissection of the anatomic specimens; this approach enabled us to compare the results and verify whether the US study and the dissection correlated on the topography of the tibial nerve and its terminal branches. We found almost total agreement between the US and dissection results, with no significant differences between the evaluations.
CONCLUSIONS: On the basis of this work, we can conclude that high-resolution US is almost 100% effective as a tool for identifying the tibial nerve and its branches, enabling the specialist to make diagnoses or perform selective treatments on each nerve branch and even to design surgical interventions by observing the patient\'s anatomy before performing the dissection.