Kodama Mitsuhiko, Tochikura Michi, Sasao Yu, Kasahara Takashi, Koyama Yuji, Aono Koji, Fujii Chieko, Shimoda Naoshi, Kurihara Yuka, Masakado Yoshihisa
Department of Rehabilitation Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Tokai J Exp Clin Med. 2014 Dec 20;39(4):172-7.
To compare sensitivities between 7 principal nerve conduction studies (NCS) for diagnosing carpal tunnel syndrome (CTS).
In 104 CTS and 64 control hands, following "Standard" NCSs were examined simultaneously: (1) Median sensory NCS; (2) segmental wrist-palm sensory NCS; (3) 4th digit latency difference; (4) 1st digit latency difference and (5) palmar mixed nerve latency difference. As "Guideline" and "Option" NCSs, we also examined: (6) Median motor distal latency and (7) second lumbrical-interossei latency difference (2LILD). Forty-nine CTS hands were divided into a milder subgroup only if action potentials could be recorded using all tests applied; that is, those with any absent potentials were excluded from the subgroup. Sensitivities and specificities were compared to each other.
In all CTS hands, the sensitivity of test (1), (2), (3), (4), (5), (6) and (7) was 83, 87, 92, 90, 90, 70 and 92%, respectively. In the milder subgroup, it was 67, 78, 84, 82, 84, 43, and 84% in the same order. There was no statistical difference between Standard tests and 2LILD. Specificities of all tests were over 95%.
All "Standard" tests and 2LILD have high comparable sensitivities. Therefore, 2LILD should be recommended as "Standard" NCS detecting CTS.
比较7项主要神经传导研究（NCS）诊断腕管综合征（CTS）的敏感性。
对104例CTS患者的手和64例对照者的手同时进行以下“标准”NCS检查：（1）正中神经感觉NCS；（2）节段性腕-掌感觉NCS；（3）第4指潜伏期差异；（4）第1指潜伏期差异；（5）掌侧混合神经潜伏期差异。作为“指南”和“可选”NCS，我们还检查了：（6）正中神经运动远端潜伏期；（7）第二蚓状肌-骨间肌潜伏期差异（2LILD）。仅当使用所有应用测试均可记录动作电位时，49例CTS患者的手才被分为较轻亚组；也就是说，任何无电位的患者均被排除在该亚组之外。比较各测试的敏感性和特异性。
在所有CTS患者的手中，测试（1）、（2）、（3）、（4）、（5）、（6）和（7）的敏感性分别为83%、87%、92%、90%、90%、70%和92%。在较轻亚组中，按相同顺序分别为67%、78%、84%、82%、84%、43%和84%。标准测试与2LILD之间无统计学差异。所有测试的特异性均超过95%。
所有“标准”测试和2LILD具有高度可比的敏感性。因此，应推荐2LILD作为检测CTS的“标准”NCS。
