Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195, USA.
Ultrasound Med Biol. 2012 Jun;38(6):982-8. doi: 10.1016/j.ultrasmedbio.2012.02.021. Epub 2012 Apr 12.
The transverse carpal ligament (TCL) forms the palmar boundary of the carpal tunnel and plays an important role in carpal tunnel mechanics. TCL hypertrophy has been observed for individuals with carpal tunnel syndrome (CTS) and postulated as a potential etiologic factor. Ultrasound is particularly advantageous for TCL imaging because of its capability of detecting the interfaces between the TCL and other tissues. The purposes of this study were to develop an ultrasound based method to measure the TCL thickness and to test the validity and reliability of this method. Three operators conducted two sessions of ultrasound examination on eight cadaveric specimens and eight healthy volunteers. A custom script was used to calculate TCL thickness along the TCL length from the ultrasound images. The ultrasound based TCL thickness of the cadaveric specimens was compared with the dissection based TCL thickness for validation. The results showed Pearson's correlation coefficients of 0.867-0.928, intraclass correlation coefficient (ICC) values of 0.726-0.865, a standard error of measurement of 0.02-0.07 mm and a minimal detectable difference of 0.05-0.15 mm. The high correlation coefficients and small errors indicate that the ultrasound based method is valid for measuring TCL thickness. Furthermore, ultrasound measurements showed excellent intraoperator and interoperator reliability with ICC values as 0.826-0.933 and 0.840-0.882, respectively. The ultrasound based TCL thickness was in the range of 0.93-2.34 (1.54 ± 0.33) mm and agreed well with previous studies. The ultrasound method developed in this study is a valuable tool to examine morphologic properties of healthy and pathologic TCLs.
腕横韧带（TCL）构成腕管的掌侧边界，在腕管力学中起着重要作用。已经观察到患有腕管综合征（CTS）的个体的 TCL 肥大，并推测其为潜在的病因。由于超声能够检测 TCL 与其他组织之间的界面，因此特别有利于 TCL 成像。本研究的目的是开发一种基于超声的方法来测量 TCL 厚度，并测试该方法的有效性和可靠性。三名操作员对 8 个尸体标本和 8 名健康志愿者进行了两次超声检查。使用自定义脚本从超声图像中计算 TCL 长度上的 TCL 厚度。为了验证，将尸体标本的基于超声的 TCL 厚度与解剖学的 TCL 厚度进行了比较。结果显示，尸检标本的超声 TCL 厚度与解剖学 TCL 厚度之间的 Pearson 相关系数为 0.867-0.928，组内相关系数（ICC）值为 0.726-0.865，测量误差为 0.02-0.07mm，最小可检测差值为 0.05-0.15mm。高相关系数和小误差表明，基于超声的方法可有效测量 TCL 厚度。此外，超声测量具有极好的操作者内和操作者间可靠性，ICC 值分别为 0.826-0.933 和 0.840-0.882。基于超声的 TCL 厚度范围为 0.93-2.34（1.54±0.33）mm，与先前的研究结果吻合较好。本研究中开发的超声方法是检查健康和病理 TCL 形态学特性的有价值工具。
