From the Department of Neurology and Clinical Neurophysiology, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands (FC, KMK, JM, WIMV); Department of Neurology, Vlietland Hospital, Schiedam, the Netherlands (FC); and Department of Neurology and Clinical Neurophysiology, St Lucas Andreas Hospital, Amsterdam, the Netherlands (KMK).
Am J Phys Med Rehabil. 2013 Nov;92(11):1005-11. doi: 10.1097/PHM.0b013e31829b4bd8.
The aims of this study were to compare electrodiagnostic (EDX) confirmation of clinical diagnosis of carpal tunnel syndrome (CTS) with ultrasonography (US), using a new set of normal values taking wrist circumference of subjects into account, and to determine whether EDX examination can be replaced by US to confirm CTS.
A prospective cohort of 156 patients with idiopathic CTS underwent US and EDX studies. Upper levels of normal cross-sectional area of the median nerve were established by taking wrist circumference into account and using linear regression equations.
Of the selected patients, 83.3% met the EDX criteria for CTS. The findings from the US were normal in 67 (42.9%) of 156 patients, and within this group, the findings from the EDX were abnormal in 44 patients (65.7%). Of 89 patients with abnormal findings from the US, only 3 patients had normal findings from the EDX.
US cannot replace EDX for confirmation of clinical diagnosis of CTS. However, an abnormal US test result has a high positive predictive value for abnormal EDX result in clinically defined CTS. US might reveal relevant anatomic information preoperatively that rarely has a direct influence on treatment management of patients with CTS. US testing, taking morphometric data into account, does not have the same diagnostic value as EDX does in confirming CTS.
本研究旨在比较考虑腕围的新正常数值集的电诊断（EDX）对腕管综合征（CTS）的临床诊断的确认与超声（US）的结果，以确定 EDX 检查是否可以替代 US 来确认 CTS。
一项前瞻性队列研究纳入了 156 例特发性 CTS 患者，进行 US 和 EDX 研究。通过线性回归方程考虑腕围来确定正中神经的正常横截面积的上限。
在入选的患者中，83.3%符合 CTS 的 EDX 标准。156 例患者中有 67 例（42.9%）US 结果正常，在此组中，44 例（65.7%）EDX 结果异常。在 89 例 US 异常的患者中，仅有 3 例 EDX 结果正常。
US 不能替代 EDX 来确认 CTS 的临床诊断。然而，US 异常的结果对于临床定义的 CTS 中 EDX 异常的结果具有较高的阳性预测值。US 可能在术前揭示相关的解剖学信息，但这些信息很少直接影响 CTS 患者的治疗管理。考虑形态计量数据的 US 测试在确认 CTS 方面与 EDX 没有相同的诊断价值。
