Study On Ultrasonic Measurement Of Brachial Plexus Crosssectional Area In Normal Adults And In The Diagnosis Of Brachial Plexus Nerve Root Compression In Cervical Spondylosis

Objective: The purpose of this study was to study the ultrasonic measurement range of C5,C6 and C7 nerve root cross-sectional area(CSA)in normal adults and its influencing factors,analyze the differences of brachial plexus nerve root CSA in normal adults and patients with cervical spondylosis nerve root compression,and discuss its diagnostic significance for brachial plexus nerve root compression.Methods :(1)a total of 100 healthy volunteers who underwent highfrequency ultrasound examination in the first affiliated hospital of Guangxi medical university from April 2019 to October 2019 were selected as the normal control group.High-frequency ultrasound was used to measure the nerve root CSA at the bilateral C5,C6 and C7 levels of each subject at each marker point.Age,gender,height,weight and other information of the control group were collected,and body mass index(BMI)was calculated based on height and weight.The aim was to investigate the ultrasonic values of nerve roots CSA at various levels of C5,C6 and C7 in normal adults,and to conduct statistical analysis on the factors that may affect the measured values.(2)56 patients with suspected cervical spondylotic radiculopathy admitted to the first affiliated hospital of Guangxi medical university from April 2019 to October 2019 were selected as the control group.High frequency ultrasound was used to measure the bilateral C5,C6,C7 nerve root CSA of each subject at each marker.They were divided into the nerve root compression group and the nerve root uncompression group according to the MRI result.Then,the differences of CSA ultrasonic measurements of nerve roots in the normal control group,the nerve root compression group and the nerve root uncompression group were analyzed.Finally,ROC curve was made to determine the optimal critical value for the diagnosis of nerve root compression at various levels of C5～C7.Results:(1)Normal ultrasonic measurements of cross-sectional area of nerve roots were(5.50±0.71)mm~2 for C5,(8.47±0.86)mm~2 for C6,and(8.84±1.06)mm~2 for C7.(2)analysis of influencing factors: there was no significant statistical difference between CSA ultrasonic measurements of nerve roots at the three levels,between different age,genders and BMI groups(all P > 0.05).(3)the ultrasonic values of CSA in the C5,C6 and C7 nerve root compression group were significantly higher than those in the non-nerve root compression group and the normal control group(all P < 0.05),which indicate statistically significant differences.There was no significant difference in CSA ultrasonic measurements between the non-compression group of C5,C6 and C7 nerve roots and the normal control group(all P > 0.05),and the difference was not statistically significant.(4)the ROC curve was established to determine the optimal critical value for the diagnosis of nerve root compression at various levels of C5,C6 and C7.The ROC curve area was 0.907,0.967 and 0.914,respectively and accordingly the The optimal critical value for diagnosis was 6.61 mm~2,9.23 mm~2 and 10.56 mm~2.Conclusion: High-frequency ultrasound can better display the brachial plexus nerve root,and the CSA of the brachial plexus nerve root measured by ultrasound,can be used as a simple auxiliary diagnosis method for the clinical diagnosis of cervical spondylosis nerve root compression.