Kwon Bong Cheol, Jung Kwang-Ik, Baek Goo Hyun
Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Kyeonggido, Korea.
J Hand Surg Am. 2008 Jan;33(1):65-71. doi: 10.1016/j.jhsa.2007.10.014.
To determine whether sonography can be an alternative method to nerve conduction study (NCS) in the diagnosis of carpal tunnel syndrome (CTS), by comparing sonography with nerve conduction study using clinical diagnosis as the reference standard.
Forty-one wrists of 29 patients were enrolled, along with the same number of age- and gender-matched controls. All patients had sonographic measurement of the cross-sectional area (CSA) of the median nerve and NCS. Sensitivity and specificity were obtained and compared between sonography and NCS.
There were no significant differences in age, gender, body mass index and involved side between patients and controls (p<.05). The CSA at the tunnel inlet was significantly larger in patients than in controls (p=.03). The best cutoff value of CSA at the tunnel inlet was 10.7 mm(2), which had a sensitivity of 66% and a specificity of 63%. NCS showed a sensitivity of 78% and a specificity of 83%. Sensitivity was similar between sonography and NCS (p=0.27), whereas specificity was significantly lower in sonography than in NCS (p=0.02).
Sonography is not accurate enough to replace NCS for the diagnosis of CTS.
TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic III.
通过将超声检查与以临床诊断为参考标准的神经传导研究进行比较，确定超声检查是否可作为诊断腕管综合征（CTS）的神经传导研究的替代方法。
纳入29例患者的41只手腕，以及相同数量的年龄和性别匹配的对照。所有患者均接受正中神经横截面积（CSA）的超声测量和神经传导研究。获得超声检查和神经传导研究之间的敏感性和特异性并进行比较。
患者和对照在年龄、性别、体重指数和受累侧别方面无显著差异（p<0.05）。患者腕管入口处的CSA显著大于对照（p = 0.03）。腕管入口处CSA的最佳截断值为10.7mm²，其敏感性为66%，特异性为63%。神经传导研究显示敏感性为78%，特异性为83%。超声检查和神经传导研究之间的敏感性相似（p = 0.27），而超声检查的特异性显著低于神经传导研究（p = 0.02）。
超声检查在诊断腕管综合征方面不够准确，不足以替代神经传导研究。
研究类型/证据水平：诊断性III级。
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