Pastare D, Therimadasamy A K, Lee E, Wilder-Smith E P
Neurology, National University Health Systems, 5 Lower Kent Ridge Road, 119074, Singapore.
J Clin Ultrasound. 2009 Sep;37(7):389-93. doi: 10.1002/jcu.20601.
To compare the diagnostic value of high-resolution ultrasound (US) with nerve conduction studies (NCS) in patients with clinically defined carpal tunnel syndrome (CTS).
A prospective study was conducted on 66 consecutive patients investigated for sensory hand symptoms. The gold standard was the clinical diagnosis of CTS.
NCS showed greater diagnostic sensitivity (82%) than US (62%) in supporting a diagnosis of CTS. With increasing neurophysiologic severity of median neuropathy, there was increasing convergence of the two test methods. Abnormal US as the only diagnostic supportive evidence of CTS was rare. However, the positive predictive value of US for CTS was 100%.
NCS show better sensitivity than US in supporting a diagnosis of CTS. However, because of its high positive predictive value, one may consider using US as a screening test, eliminating the need for NCS in the majority of clinical suspicion of CTS and reserving NCS for cases in which US is negative.
比较高分辨率超声（US）与神经传导研究（NCS）对临床确诊为腕管综合征（CTS）患者的诊断价值。
对66例因手部感觉症状接受检查的连续患者进行前瞻性研究。金标准为CTS的临床诊断。
在支持CTS诊断方面，NCS显示出比US更高的诊断敏感性（82%对62%）。随着正中神经病变神经生理学严重程度的增加，两种检测方法的一致性增加。异常US作为CTS唯一诊断支持证据的情况很少见。然而，US对CTS的阳性预测值为100%。
在支持CTS诊断方面，NCS比US具有更好的敏感性。然而，由于其高阳性预测值，可以考虑将US用作筛查试验，在大多数临床怀疑CTS的情况下无需进行NCS，而仅在US为阴性的病例中进行NCS。
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