Lu Yuji, Meng Zengdong, Pan Xuekun, Qin Libo, Wang Gang
Department of Emergency Trauma Surgery, The First People's Hospital of Yunnan Province Kunming 650032, Yunnan, China.
Department of Orthopaedic Surgery, The First People's Hospital of Yunnan Province Kunming 650032, Yunnan, China.
Int J Clin Exp Med. 2015 Dec 15;8(12):22418-24. eCollection 2015.
This study aimed to evaluate the diagnostic value of high-frequency ultrasound examination for carpal tunnel syndrome (CTS). A total of 63 wrists from 45 patients diagnosed with CTS were selected as the study group, and 43 asymptomatic wrists of 40 cases were included as the normal control group. Parameters such as the transverse diameter, vertical diameter, cross-sectional area (CSA), and flattening rate (FR) of the carpal tunnel radioulnar joint, postular bone, and median nerve in the hamate bone hook plane were measured, and the differences between the two groups were compared. The median nerve CSA in the postular bone plate was significantly greater in the study group than in the normal control group (0.17±0.05 vs. 0.09±0.02, P<0.01), and the FR at the hook of the hamate was significantly higher in the study group (3.52±0.86 vs. 3.21±0.26, P<0.01). Our results suggest that ultrasonography can effectively provide dynamic real-time images of the wrist in addition to being painless, non-invasive, and associated with relatively low costs. Based on our findings, we believe that ultrasonography is an effective examination method for CTS. When the threshold of the median nerve CSA in the postular bone plate was set as 10 mm(2), the diagnostic sensitivity and specificity were 92% and 86%, respectively. Therefore, the median nerve CSA may represent a good clinical indicator of CTS.
本研究旨在评估高频超声检查对腕管综合征(CTS)的诊断价值。选取45例确诊为CTS患者的63只手腕作为研究组,纳入40例43只无症状手腕作为正常对照组。测量钩骨平面腕管尺桡关节、豆状骨及正中神经的横径、垂直径、横截面积(CSA)和平坦率(FR)等参数,并比较两组间差异。研究组豆状骨板处正中神经CSA显著大于正常对照组(0.17±0.05对0.09±0.02,P<0.01),且研究组钩骨处FR显著更高(3.52±0.86对3.21±0.26,P<0.01)。我们的结果表明,超声检查除无痛、无创且成本相对较低外,还能有效提供手腕的动态实时图像。基于我们的研究结果,我们认为超声检查是CTS的一种有效检查方法。当将豆状骨板处正中神经CSA阈值设定为10 mm²时,诊断敏感性和特异性分别为92%和86%。因此,正中神经CSA可能是CTS的一个良好临床指标。