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Role of High Frequency Ultrasound in Diagnosing Carpal Tunnel Syndrome as Compared with Conventional Nerve Conduction Studies
Annals of Indian Academy of Neurology ( IF 1.9 ) Pub Date : 2020-09-01 , DOI: 10.4103/aian.aian_469_19 Monika Singla 1 , Mukesh K Sharma 2 , Dheraj Khurana 3 , Vivek Lal 3
Objective: Our aim was to evaluate High Frequency Ultrasonography as a tool for diagnosis in patients withcarpal tunnel syndrome in comparison with electrophysiological study. Methods: Thirty- one patients [56 hands] with CTS and twenty-five asymptomatic controls [50 hands] were assessed and underwent ultrasonography of the wrists and electrophysiological testing. Data from the patient and the control groups was compared for both the investigations to determine the CTS and the grade of severity. Results: There was a high degree of correlation between the conduction abnormalities of the median nerve as detected by electrodiagnostic tests, historic and objective scale [Hi-Ob] and the measurement of the cross-sectional area of the nerve by US (P < 0.05). A cut-off point of 0.88 mm2 for the mean cross-sectional area of the median nerve was found to be the upper limit for normal values. Compared to Ultrasonography which found one hand negative, six hands (10%) were negative on the electrophysiological tests. Using critical CSA value of 1.0 mm2 in these CTS cases by US with sensitivity and specificity of 100% and 88%. Based on the results of this study, ultrasonography of wrist is another useful tool along with nerve conduction studies as per sensitivity and specificity patterns found in our study in diagnosis of carpal tunnel syndrome. Conclusion: High-frequency US examination of the median nerve and measurement of its cross-sectional area can be strongly considered as useful diagnostic diagnostic modality for the evaluation of CTS along with nerve conduction studies. In addition to its high diagnostic accuracy it is able to define the cause of nerve compression, aids treatment planning and provides a reliable method to follow response to therapy.
中文翻译：
与常规神经传导研究相比，高频超声在诊断腕管综合征中的作用
目的：我们的目的是评估高频超声检查作为诊断腕管综合征患者的工具，并与电生理研究进行比较。方法：对 31 名 CTS 患者 [56 只手] 和 25 名无症状对照者 [50 只手] 进行了评估，并接受了腕部超声检查和电生理测试。比较来自患者和对照组的数据，以确定 CTS 和严重程度等级。结果：电诊断、历史客观量表[Hi-Ob]检测到的正中神经传导异常与US测量的神经横截面积有高度相关性（P< 0.05)。发现正中神经的平均横截面积为 0.88 mm 2的截止点是正常值的上限。与发现一只手呈阴性的超声检查相比，六只手（10%）的电生理测试呈阴性。美国在这些 CTS 病例中使用 1.0 mm 2的临界 CSA 值，敏感性和特异性分别为 100% 和 88%。根据本研究的结果，根据我们在腕管综合征诊断研究中发现的敏感性和特异性模式，腕部超声检查与神经传导研究一起是另一个有用的工具。结论：正中神经的高频超声检查及其横截面积的测量可以被强烈认为是评估 CTS 以及神经传导研究的有用诊断诊断方式。除了其高诊断准确性之外，它还能够确定神经压迫的原因、帮助制定治疗计划并提供一种可靠的方法来跟踪对治疗的反应。
更新日期：2020-09-01
Annals of Indian Academy of Neurology ( IF 1.9 ) Pub Date : 2020-09-01 , DOI: 10.4103/aian.aian_469_19 Monika Singla 1 , Mukesh K Sharma 2 , Dheraj Khurana 3 , Vivek Lal 3
Affiliation
Objective: Our aim was to evaluate High Frequency Ultrasonography as a tool for diagnosis in patients withcarpal tunnel syndrome in comparison with electrophysiological study. Methods: Thirty- one patients [56 hands] with CTS and twenty-five asymptomatic controls [50 hands] were assessed and underwent ultrasonography of the wrists and electrophysiological testing. Data from the patient and the control groups was compared for both the investigations to determine the CTS and the grade of severity. Results: There was a high degree of correlation between the conduction abnormalities of the median nerve as detected by electrodiagnostic tests, historic and objective scale [Hi-Ob] and the measurement of the cross-sectional area of the nerve by US (P < 0.05). A cut-off point of 0.88 mm2 for the mean cross-sectional area of the median nerve was found to be the upper limit for normal values. Compared to Ultrasonography which found one hand negative, six hands (10%) were negative on the electrophysiological tests. Using critical CSA value of 1.0 mm2 in these CTS cases by US with sensitivity and specificity of 100% and 88%. Based on the results of this study, ultrasonography of wrist is another useful tool along with nerve conduction studies as per sensitivity and specificity patterns found in our study in diagnosis of carpal tunnel syndrome. Conclusion: High-frequency US examination of the median nerve and measurement of its cross-sectional area can be strongly considered as useful diagnostic diagnostic modality for the evaluation of CTS along with nerve conduction studies. In addition to its high diagnostic accuracy it is able to define the cause of nerve compression, aids treatment planning and provides a reliable method to follow response to therapy.
中文翻译：
与常规神经传导研究相比，高频超声在诊断腕管综合征中的作用
目的：我们的目的是评估高频超声检查作为诊断腕管综合征患者的工具，并与电生理研究进行比较。方法：对 31 名 CTS 患者 [56 只手] 和 25 名无症状对照者 [50 只手] 进行了评估，并接受了腕部超声检查和电生理测试。比较来自患者和对照组的数据，以确定 CTS 和严重程度等级。结果：电诊断、历史客观量表[Hi-Ob]检测到的正中神经传导异常与US测量的神经横截面积有高度相关性（P< 0.05)。发现正中神经的平均横截面积为 0.88 mm 2的截止点是正常值的上限。与发现一只手呈阴性的超声检查相比，六只手（10%）的电生理测试呈阴性。美国在这些 CTS 病例中使用 1.0 mm 2的临界 CSA 值，敏感性和特异性分别为 100% 和 88%。根据本研究的结果，根据我们在腕管综合征诊断研究中发现的敏感性和特异性模式，腕部超声检查与神经传导研究一起是另一个有用的工具。结论：正中神经的高频超声检查及其横截面积的测量可以被强烈认为是评估 CTS 以及神经传导研究的有用诊断诊断方式。除了其高诊断准确性之外，它还能够确定神经压迫的原因、帮助制定治疗计划并提供一种可靠的方法来跟踪对治疗的反应。
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