Dehghan Farnaz, Haghighat Shila, Ramezanian Hadiseh, Karami Mehdi, Rezaei Mohammad Reza
Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2018 Feb 16;7:22. doi: 10.4103/2277-9175.225591. eCollection 2018.
The aim of this study is to determine the predictive value of ultrasonography for results of local steroid injection in patients with carpal tunnel syndrome (CTS).
This prospective cohort study was conducted during a 1-year period in outpatient clinics of rehabilitation and physical medicine including 35 patients with moderate and severe CTS who receive ultrasonography-guided local steroid injection. The Boston self-assessment questionnaire and electrodiagnosis parameters were recorded at baseline, 1 month, and 3 months after therapy. We also recorded the baseline ultrasonography parameters to determine the predictors of outcome.
The sensory severity score and functional status scale along with electrodiagnosis parameters decreased significantly at 1 month ( < 0.001) and remained unchanged after 3 months. Volar bulging was negatively associated with sensory nerve action potential latency ( = -0.392; = 0.020). Cross-sectional area (CSA) of maximal swelling (MS; = 0.409; = 0.015), CSA at 2-cm of MS ( = 0.563; < 0.001), and CSA at 12-cm of MS ( = 0.521; = 0.001) correlated positively with compound muscle action potential (CMAP) amplitude while maximal swelling/12-cm MS ratio ( = -0.439; = 0.008) and maximal swelling/2-cm MS ratio ( = -0.342; = 0.045) correlated negatively. CSA at 12-cm of MS also correlated positively with CMAP amplitude nerve conduction velocity ( = 0.436; = 0.010).
Volar bulging, CSA of maximal swelling, CSA of MS at 2-cm, and CSA of MS at 12-cm are among the ultrasonographic predictors of response to local steroid injection in patients with CTS.
本研究的目的是确定超声检查对腕管综合征（CTS）患者局部注射类固醇结果的预测价值。
这项前瞻性队列研究在康复与物理医学门诊进行，为期1年，纳入35例中重度CTS患者，接受超声引导下局部注射类固醇。在治疗前、治疗后1个月和3个月记录波士顿自我评估问卷和电诊断参数。我们还记录了基线超声参数以确定结果的预测因素。
感觉严重程度评分和功能状态量表以及电诊断参数在1个月时显著降低（<0.001），3个月后保持不变。掌侧肿胀与感觉神经动作电位潜伏期呈负相关（=-0.392；=0.020）。最大肿胀处的横截面积（CSA）（=0.409；=0.015）、最大肿胀处2 cm处的CSA（=0.563；<0.001）以及最大肿胀处12 cm处的CSA（=0.521；=0.001）与复合肌肉动作电位（CMAP）振幅呈正相关，而最大肿胀/12 cm最大肿胀处比值（=-0.439；=0.008）和最大肿胀/2 cm最大肿胀处比值（=-0.342；=0.045）呈负相关。最大肿胀处12 cm处的CSA也与CMAP振幅神经传导速度呈正相关（=0.436；=0.010）。
掌侧肿胀、最大肿胀处的CSA、最大肿胀处2 cm处的CSA以及最大肿胀处12 cm处的CSA是CTS患者局部注射类固醇反应的超声预测因素。
