Hathaiareerug Chanasak, Somnam Suthida, Kumnerddee Wipoo, Phongamwong Chanwit
Department of Rehabilitation Medicine, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Bangkok, Thailand.
Prog Rehabil Med. 2022 Jul 22;7:20220037. doi: 10.2490/prm.20220037. eCollection 2022.
This study aimed to evaluate the diagnostic properties for carpal tunnel syndrome (CTS) of the median-to-ulnar cross-sectional area ratio (MUR) and the median-to-superficial radial cross-sectional area ratio (MRR).
A case-control study was conducted. A physiatrist, blinded to the CTS status of the subjects, assessed the cross-sectional area of the median nerve (CSA-m), MUR, and MRR at the distal wrist crease for the CTS and control groups. The relationship of CSA-m, MUR, and MRR with CTS severity was tested using Spearman's correlation. The overall diagnostic accuracy was determined using the area under the receiver operating characteristic curve (AUC). The cut-off values to diagnose CTS were chosen to achieve similar values for sensitivity and specificity.
There were 32 hands in the CTS group and 33 hands in the control group. The correlations of CSA-m, MUR, and MRR with CTS severity were 0.66, 0.56, and 0.34, respectively. The AUCs of CSA-m, MUR, and MRR were 0.86 (95%CI: 0.77-0.95), 0.79 (0.69-0.90), and 0.69 (0.56-0.82), respectively. The cut-off values of CSA-m, MUR, and MRR were 12 mm (sensitivity, 81.3%; specificity, 81.8%), 2.6 (sensitivity, 68.8%; specificity, 69.7%), and 10 (sensitivity, 65.6%; specificity, 63.6%), respectively.
: MUR and MRR had acceptable diagnostic abilities but did not show superiority over CSA-m for CTS diagnosis.
本研究旨在评估正中神经与尺神经横截面积比（MUR）和正中神经与桡浅神经横截面积比（MRR）对腕管综合征（CTS）的诊断价值。
进行了一项病例对照研究。一名对受试者CTS状态不知情的物理治疗师评估了CTS组和对照组在腕部远侧腕横纹处正中神经横截面积（CSA-m）、MUR和MRR。使用Spearman相关性检验CSA-m、MUR和MRR与CTS严重程度的关系。使用受试者操作特征曲线下面积（AUC）确定总体诊断准确性。选择诊断CTS的临界值以实现相似的敏感性和特异性值。
CTS组有32只手，对照组有33只手。CSA-m、MUR和MRR与CTS严重程度的相关性分别为0.66、0.56和0.34。CSA-m、MUR和MRR的AUC分别为0.86（95%CI：0.77-0.95）、0.79（0.69-0.90）和0.69（0.56-0.82）。CSA-m、MUR和MRR的临界值分别为12mm（敏感性，81.3%；特异性，81.8%）、2.6（敏感性，68.8%；特异性，69.7%）和10（敏感性，65.6%；特异性，63.6%）。
MUR和MRR具有可接受的诊断能力，但在CTS诊断方面未显示出优于CSA-m的优势。
