Xu L, Chen F M, Wang L, Zhang P X, Jiang X R
Department of Hand and Foot Surgery, Yantai Affiliated Hospital of Binzhou Medical University, Yantai 264001, Shandong, China.
Department of Trauma and Orthopaedics, Peking University People's Hospital; Peking University Traffic Medicine Center, Beijing 100044, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2016 Apr 18;48(2):341-5.
To evaluate the meaning and value of high-frequency ultrasound in the diagnosis of carpal tunnel syndrome (CTS).
In this study, 48 patients (unilateral hand) with CTS were analyzed. The thickness of transverse carpal ligaments at the pisiform bone was measured using high-frequency ultrasound. Open carpal tunnel release procedure was performed in the 48 CTS patients, and the thickness of transverse carpal ligaments at the hamate hook bone measured using vernier caliper under direct vision. The accuracy of thickness of transverse carpal ligaments was evaluated using high-frequency ultrasound. high-frequency ultrasound measurement of thickness of transverse carpal ligaments at the hamate hook bone and pisiform bone, and determination of the diagnostic threshold measurement index using receiver operating characteristic (ROC) curve, sensitivity and specificity were performed and the correlation between the thickness of transverse carpal ligaments and nerve conduction study (NCS) analyzed.
The thickness of transverse carpal ligaments in the CTS patients were (0.42±0.08) cm (high-frequency ultrasound) and (0.41±0.06) cm (operation) at hamate hook bone, and there was no significant difference between the two ways (t=0.672, P>0.05). The optimal cut-off value of the transverse carpal ligaments at hamate hook bone was 0.385 cm, the sensitivity 0.775, and the specificity 0.788. The optimal cut-off value of the transverse carpal ligaments at the pisiform bone was 0.315 cm, the sensitivity 0.950, and the specificity 1.000. The transverse carpal ligaments thickness and wrist-index finger sensory nerve conduction velocity (SCV), wrist-middle finger SCV showed a negative correlation.
High frequency ultrasound measurements of thickness of transverse carpal ligaments is a valuable method for the diagnosis of CTS.
评估高频超声在诊断腕管综合征（CTS）中的意义和价值。
本研究分析了48例单侧手部患有CTS的患者。使用高频超声测量豌豆骨处腕横韧带的厚度。对这48例CTS患者进行开放性腕管松解手术，并在直视下用游标卡尺测量钩骨处腕横韧带的厚度。评估高频超声测量腕横韧带厚度的准确性。进行高频超声测量钩骨和豌豆骨处腕横韧带的厚度，利用受试者工作特征（ROC）曲线确定诊断阈值测量指标，计算敏感性和特异性，并分析腕横韧带厚度与神经传导研究（NCS）之间的相关性。
CTS患者钩骨处腕横韧带厚度高频超声测量值为（0.42±0.08）cm，手术测量值为（0.41±0.06）cm，两种方法差异无统计学意义（t = 0.672，P>0.05）。钩骨处腕横韧带的最佳截断值为0.385 cm，敏感性为0.775，特异性为0.788。豌豆骨处腕横韧带的最佳截断值为0.315 cm，敏感性为0.950，特异性为1.000。腕横韧带厚度与腕-示指感觉神经传导速度（SCV）、腕-中指SCV呈负相关。
高频超声测量腕横韧带厚度是诊断CTS的一种有价值的方法。
