Carpal Tunnel Syndrome: Diagnostic Usefulness of Ultrasound Measurement of the Median Nerve Area and Quantitative Elastographic Measurement of the Median Nerve Stiffness
| Autor: | Gianluca Martinelli, Ana Royuela, Alberto Perez de Vargas, Ana Lopez, Luz M. Moran, Yamilet Cepeda |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male macromolecular substances Severity of Illness Index 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Electrodiagnostic testing Elastic Modulus Humans Medicine Cutoff Radiology Nuclear Medicine and imaging In patient Prospective Studies Carpal tunnel syndrome Aged Aged 80 and over Shear wave elastography 030219 obstetrics & reproductive medicine Radiological and Ultrasound Technology medicine.diagnostic_test business.industry Electrodiagnosis Ultrasound Middle Aged medicine.disease Carpal Tunnel Syndrome Median nerve Median Nerve nervous system diseases Female Elastography business Nuclear medicine |
| Zdroj: | Journal of Ultrasound in Medicine. 39:331-339 |
| ISSN: | 1550-9613 0278-4297 |
| DOI: | 10.1002/jum.15111 |
| Popis: | Objectives To correlate the ultrasound (US) measurements of the median nerve cross-sectional area (CSA) and the measurements of its stiffness by shear wave elastography (SWE) with the severity grade of carpal tunnel syndrome (CTS) using electrodiagnostic testing (EDT) and to determine the cutoff points for CSA and SWE measurements to allow us to discriminate patients with moderate and severe CTS from those with mild or negative EDT findings. Methods Seventy-three patients with 105 hands with a clinical suspicion of CTS were studied with US and SWE. We measured the median nerve CSA and elasticity (E) at the tunnel inlet (CSAu and Eu), in the quadratus pronator (CSAo and Eo), and the differences (CSAu - CSAo and Eu - Eo). Results The nerve area and stiffness increased according to the EDT severity of CTS; the CSA increased proportionally as CTS increased from negative to severe according to EDT, and the stiffness was not different between patients with negative and mild EDT findings but was higher in patients with moderate and severe EDT findings versus negative and mild EDT findings. The cutoff points of a CSAu of 14 mm2 or greater and an Eu - Eo of 57 kPa or greater together allowed the discrimination of moderate and severe CTS from the rest. Conclusions The joint use of US and SWE is an alternative to EDT in the clinical management and treatment of patients with a clinical suspicion of CTS. |
| Databáze: | OpenAIRE |
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