Department of Radiology, Osmangazi University Hospital, Turkey.
Korean J Radiol. 2010 Nov-Dec;11(6):632-9. doi: 10.3348/kjr.2010.11.6.632. Epub 2010 Oct 29.
To determine the value of gray-scale and power Doppler ultrasonography in the evaluation of carpal tunnel syndrome (CTS).
Median nerves at the carpal tunnel were evaluated by using gray-scale and power Doppler ultrasonography and by using accepted and new criteria in 42 patients with CTS (62 wrists) confirmed by electromyogram and 33 control subjects. We evaluated the cross-sectional area of the nerve just proximal to the tunnel inlet (CSAa), and at mid level (CSAb). We then calculated the percentage area increase of CSAb, and area difference (CSAb-CSAa). We measured two dimensions of the nerve at the distal level to calculate the flattening ratio. The power Doppler ultrasonography was used to assess the number of vessels, which proceeded to give a score according to the vessel number, and lastly evaluated the statistical significance by comparing the means of patients with control subjects by the Student t test for independent samples. Sensitivities and specificities were determined for sonographic characteristics mentioned above. We obtained the receiver operating characteristic (ROC) curve to assess the optimal cut-off values for the diagnosis of CTS.
A statistically significant difference was found between patients and the control group for mean CSAb, area difference, percentage area increase, and flattening ratio (p < 0.001, p < 0.001, p < 0.001, p < 0.05, respectively). From the ROC curve we obtained optimal cut-off values of 11 mm(2) for CSAb, 3.65 for area difference, 50% for the percentage of area increase, and 2.6 for the flattening ratio. The mean number of vessels obtained by power Doppler ultrasonography from the median nerve was 1.2. We could not detect vessels from healthy volunteers. Mean CSAbs related to vascularity intensity scores were as follows: score 0: 12.3 ± 2.8 mm(2), score 1: 12.3 ± 3.1 mm(2), score 2: 14.95 ± 3.5 mm(2), score 3: 19.3 ± 3.8 mm(2). The mean PI value in vessels of the median nerve was 4.1 ± 1.
Gray-scale and power Doppler ultrasonography are useful in the evaluation of CTS.
确定灰阶和能量多普勒超声在腕管综合征（CTS）评估中的价值。
使用灰阶和能量多普勒超声检查 42 例经肌电图证实的 CTS 患者（62 个腕部）和 33 例对照者的正中神经在腕管入口处近端（CSAa）和中部（CSAb）的横截面积。然后计算 CSAb 的面积增加百分比和面积差（CSAb-CSa）。我们测量远端水平的神经的两个维度，以计算扁平比。能量多普勒超声用于评估血管数量，并根据血管数量进行评分，最后通过独立样本学生 t 检验比较患者和对照组的平均值来评估统计学意义。确定上述超声特征的敏感性和特异性。我们获得了受试者工作特征（ROC）曲线，以评估 CTS 诊断的最佳截断值。
患者与对照组之间 CSAb、面积差、面积增加百分比和扁平比的平均值有统计学差异（p<0.001、p<0.001、p<0.001、p<0.05）。从 ROC 曲线中，我们得出了 CSAb 的最佳截断值为 11mm²、面积差为 3.65、面积增加百分比为 50%、扁平比为 2.6。从中获取的正中神经血管数量平均值为 1.2。我们无法从健康志愿者中检测到血管。与血管强度评分相关的平均 CSAbs 如下：评分 0：12.3±2.8mm²、评分 1：12.3±3.1mm²、评分 2：14.95±3.5mm²、评分 3：19.3±3.8mm²。正中神经血管的平均 PI 值为 4.1±1。
灰阶和能量多普勒超声在 CTS 的评估中是有用的。
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