Beekman Roy, Visser Leo H
Department of Neurology, St. Elisabeth Hospital, P.O. Box 90151, 5000 LC Tilburg, The Netherlands.
Muscle Nerve. 2003 Jan;27(1):26-33. doi: 10.1002/mus.10227.
Advances in ultrasound technology have made it possible to gain higher spatial resolution and even depict nerves with excellent visual quality. In this article, the literature concerning sonography in the diagnosis of carpal tunnel syndrome (CTS) is critically reviewed. We searched Medline for studies on sonography in the diagnosis of CTS and used the reference lists of the articles found. A total of seven studies on the diagnostic capabilities of sonography was found. There were considerable differences in study design. A reliable diagnosis of CTS could be made sonographically, mainly based on an increase in cross-sectional area of the median nerve at the level of the pisiform or hamate bone. However, most studies could not compare the diagnostic capabilities of sonography to those of electrodiagnostic studies, because the latter was applied as the gold standard. Several other reports on the possible extra value of sonography in CTS are mentioned (mass lesions, anatomical variants, rheumatological diseases, renal dialysis-related amyloidosis, surgery, corticosteroid injection). It is probable that sonography will not replace electrodiagnostic studies, but may serve as an additional investigation. To gain further insight into the possible additional value of sonography, it is necessary to examine subcategories of CTS patients in which electrodiagnostic studies are equivocal.
超声技术的进步使得获得更高的空间分辨率甚至以优异的视觉质量描绘神经成为可能。在本文中，对有关超声检查诊断腕管综合征（CTS）的文献进行了批判性综述。我们在Medline上搜索了关于超声检查诊断CTS的研究，并使用了所找到文章的参考文献列表。共找到七项关于超声检查诊断能力的研究。研究设计存在相当大的差异。超声检查能够做出CTS的可靠诊断，主要依据是在豌豆骨或钩骨水平正中神经横截面积的增加。然而，大多数研究无法将超声检查的诊断能力与电诊断研究的能力进行比较，因为后者被用作金标准。还提到了其他几篇关于超声检查在CTS中可能的额外价值的报告（肿块病变、解剖变异、风湿性疾病、肾透析相关淀粉样变性、手术、皮质类固醇注射）。超声检查很可能不会取代电诊断研究，但可作为一项补充检查。为了进一步了解超声检查可能的额外价值，有必要对电诊断研究结果不明确的CTS患者亚组进行研究。
