scholarly journals The diagnostic accuracy of median nerve ultrasonography in elderly patients with carpal tunnel syndrome: sensitivity and specificity assessment

2018 ◽  
Vol Volume 13 ◽  
pp. 1953-1962 ◽  
Author(s):  
Reza Salman Roghani ◽  
Seyed Ebrahim Hashemi ◽  
Mohammad Taghi Holisaz ◽  
Faeze Gohari ◽  
Ahmad Delbari ◽  
...  
2021 ◽  
pp. 1-4
Author(s):  
Maripi Gnani ◽  
Sirisha Naidu ◽  
Ch. Madhavi ◽  
G.S. Kejriwal

Background: Although controversial, recent studies have demonstrated advantages of sonographic techniques in the diagnosis of carpal tunnel syndrome (CTS). The purpose of this study was to assess the utility of median nerve ultrasonography in the diagnosis of CTS in Indian patients. Methods: Ninety patents with clinically suspected CTS were studied. Based on gold standard electromyography/nerve conduction ve-locity studies, wrists with CTS were divided into three groups on the basis of severity of CTS, ie, mild, moderate, and severe. In addition, both sides of the wrist were examined using sonography. Transverse images of the median nerve were obtained and median nerve cross-section areas were measured at three levels, ie, immediately proximal to the carpal tunnel inlet, at the carpal tunnel inlet, and at the carpal tunnel outlet. Furthermore, flexor retinaculum thickness was evaluated. Results: The mean age of the studied patients was 48.52  12.17 years. Median values of the median nerve cross-section at the carpal tunnel in-let, carpal tunnel outlet, and proximal carpal tunnel significantly differed between the wrists with and without CTS (P < 0.05). Comparisons be-tween the CTS groups (mild, moderate, and severe) and non-CTS wrists demonstrated that the median cross-sections of median nerve at the carpal tunnel inlet, carpal tunnel outlet, and inlet proximal carpal tunnel were significantly greater in the severe CTS group than in the other three groups (P < 0.05). The results showed that the median nerve cross-section at the three levels of carpal tunnel could only fairly differentiate se-vere CTS from other cases. Conclusion: The present study demonstrated that median nerve ultrasonography cannot replace the gold standard test (nerve conduction velocity) for the diagnosis of CTS because of low overall sensitivity and specificity, although it might provide useful information in some patients.


2020 ◽  
Vol 3 ◽  
Author(s):  
Estevão dos Santos Diniz ◽  
Carlos M Barros ◽  
Venâncio L Pereira ◽  
Vittoria C Fares

Radiology ◽  
2014 ◽  
Vol 270 (2) ◽  
pp. 481-486 ◽  
Author(s):  
Hideaki Miyamoto ◽  
Ethan J. Halpern ◽  
Martin Kastlunger ◽  
Markus Gabl ◽  
Rohit Arora ◽  
...  

Author(s):  
Heba Refaat Ibrahim

Abstract Background Carpal tunnel syndrome (CTS) is the commonest type of peripheral nerve entrapment syndromes. The study aimed at evaluation of diagnostic value of median nerve stiffness measured by shear wave ultrasound elastography for diagnosis and differentiation of CTS severity, correlated to electrophysiological studies. This case–control study involved 40 patients (56 wrists) with CTS of different severity and 40 controls (40 wrists). All participants underwent electrophysiological study to assess the CTS severity, high-resolution conventional B-mode ultrasound to assess cross-sectional area “CSA” of median nerve at carpal tunnel, ratio of median nerve CSA at carpal tunnel and forearm, and shear wave ultrasound elastography with measurement of median nerve mean stiffness and correlation to electrophysiological results as the reference standard. Results Mean median nerve stiffness by shear wave US elastography was increased in patients with CTS compared to controls and across the different CTS severity groups (P value < 0.001 & 0.001, respectively). The cutoff value by ROC curve analysis for median nerve stiffness to differentiate between patients with CTS and control group was 65.4 kPa (P value < 0.001, 94.6% sensitivity, 97.3% specificity). Higher diagnostic accuracy was noted with the combination of shear wave elastography and conventional B-mode US with improved AUC (B-mode + shear wave; 0.962, P value < 0.001). Conclusions Shear wave ultrasound elastography of median nerve was able to discriminate different severity subgroups of CTS with high sensitivity, while conventional US couldn’t. The diagnostic accuracy of CTS was improved when combined high-resolution conventional B-mode US and complementary shear wave ultrasound elastography.


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