Oddziat Chirurgii Ogólnej i Pododdział Chirurgii Reki i Replantacji Kończyn, Szpital św. Jadwigi w Trzebnicy.
Neurol Neurochir Pol. 2009 Sep-Oct;43(5):433-8.
The aim of the study was to compare the sensitivity and specificity of ultrasonography and neurography in patients with carpal tunnel syndrome (CTS) and to estimate the critical value of cross-sectional area of median nerves.
Eighty-nine patients (153 carpal tunnels) (17 men and 72 women, mean age 62.5 years) with CTS and 50 healthy volunteers were examined. In all patients and controls standard neurographic tests were done (motor and sensory conduction velocity tests in median and ulnar nerves). Ultrasonography was done in transverse projections with estimation of cross-sectional circumference and area of median nerves.
Mean parameters of ultrasonography and neurography, except the mean latency of sensory potentials, were statistically different in the patient and control groups. Correlations between mean parameters of ultrasonography and neurography were also statistically significant. The critical value of median nerves' cross-sectional area equal to 0.1 cm2 seemed to be important in CTS diagnostics. Oedema of median nerve was observed in some CTS cases without electrophysiological changes. Radial slide of median nerve round the tendon of superficial flexor muscles of second and third fingers was observed in 68% of CTS patients.
Ultrasonographic findings correlate well with electrophysiological tests in CTS patients. Cross-sectional area equal to 0.1 cm2 is important in CTS diagnostics. Median nerve oedema, revealed in the early stage of CTS without any electrophysiological changes, might be an important factor in occurrence of subjective complaints. Radial slide of median nerve phenomenon is a common ultrasonographic finding in CTS.
本研究旨在比较超声与神经图在腕管综合征（CTS）患者中的敏感性和特异性，并估计正中神经横截面积的临界值。
89 例（153 个腕管）（17 名男性和 72 名女性，平均年龄 62.5 岁）CTS 患者和 50 名健康志愿者接受了检查。所有患者和对照者均进行了标准神经图检查（正中神经和尺神经的运动和感觉传导速度测试）。超声检查采用横切投影进行，评估正中神经的横截面积和周长。
患者组和对照组的超声和神经图的平均参数（除了感觉电位的平均潜伏期外）均有统计学差异。超声和神经图的平均参数之间也存在显著相关性。正中神经横截面积等于 0.1cm2 的临界值似乎对 CTS 诊断很重要。在一些 CTS 病例中观察到正中神经水肿，但无电生理变化。68%的 CTS 患者观察到正中神经在浅屈肌肌腱周围的桡侧滑动。
超声表现与 CTS 患者的电生理检查相关性良好。横截面积等于 0.1cm2 对 CTS 诊断很重要。在 CTS 的早期阶段，没有任何电生理变化但出现正中神经水肿，可能是出现主观症状的重要因素。正中神经桡侧滑动现象是 CTS 的常见超声表现。
