From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Division of Hand Surgery, and the Radiology Department, Selcuk University Medical Faculty.
Plast Reconstr Surg. 2021 Jun 1;147(6):1355-1360. doi: 10.1097/PRS.0000000000007940.
The objectivity of physical and electrodiagnostic tests is limited in detecting carpal tunnel syndrome and its recurrence. Predicting the median nerve blood supply using superb microvascular imaging will allow exact diagnosis and a good follow-up system. The aims of this study include using superb microvascular imaging to correlate with electromyographic diagnosis, and to determine the impact of surgery on improvement in superb microvascular imaging.
Between July of 2019 and January of 2020, 32 wrists of 21 patients were evaluated prospectively. After preoperative electrodiagnostic studies and vascular index measurement with superb microvascular imaging, open carpal tunnel release was performed by a single surgeon, and 3 months later standardized superb microvascular imaging was performed. Preoperative vascular indexes were compared with the mild, moderate, and severe electrodiagnostic study results. Preoperative and postoperative vascular index results were compared.
The average of the preoperative and postoperative imaging groups was 2.77 and 1.48, respectively, and there was a statistically significant difference between the two groups (p < 0.05). Although no significant difference was found between preoperative and postoperative vascular index values in patients presenting with mild carpal tunnel syndrome (p > 0.05), there was a significant decrease in vascular index values in patients presenting with moderate and severe carpal tunnel syndrome after surgical decompression.
Superb microvascular imaging is emerging as a groundbreaking, new, and reliable technique. Evaluation of the median nerve blood supply is a reliable method that would be helpful for early diagnosis, planning treatment, determining the severity of carpal tunnel syndrome, and postoperative follow-up.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, IV.
在检测腕管综合征及其复发方面，体格检查和电诊断检查的客观性有限。使用超微血管成像预测正中神经的血液供应，可以进行准确的诊断和良好的随访系统。本研究的目的包括使用超微血管成像与肌电图诊断相关联，并确定手术对改善超微血管成像的影响。
在 2019 年 7 月至 2020 年 1 月期间，前瞻性评估了 21 名患者的 32 个腕关节。在术前电诊断研究和超微血管成像的血管指数测量后，由一名外科医生进行开放式腕管松解术，3 个月后进行标准化的超微血管成像。将术前血管指数与轻度、中度和重度电诊断研究结果进行比较。比较术前和术后的血管指数结果。
术前和术后影像学组的平均值分别为 2.77 和 1.48，两组之间存在统计学差异（p < 0.05）。尽管在轻度腕管综合征患者中，术前和术后的血管指数值之间没有发现显著差异（p > 0.05），但在中度和重度腕管综合征患者中，手术后血管指数值明显下降。
超微血管成像正在成为一种开创性的、新的、可靠的技术。评估正中神经的血液供应是一种可靠的方法，有助于早期诊断、治疗计划、确定腕管综合征的严重程度和术后随访。
临床问题/证据水平：诊断，IV。
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