Clinical Institute of Radiology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Department of Radiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Semin Musculoskelet Radiol. 2024 Dec;28(6):661-671. doi: 10.1055/s-0044-1790561. Epub 2024 Nov 19.
Carpal tunnel syndrome (CTS), the most common mononeuropathy, results from compression of the median nerve within the fibro-osseous carpal tunnel. Diagnosis is typically based on clinical evaluation and confirmed by nerve conduction studies. However, ultrasound (US) has emerged as a valuable noninvasive adjunct for CTS confirmation, offering potential advantages over electrodiagnostic testing in terms of patient comfort and diagnostic accuracy. This review begins with a concise summary of carpal tunnel anatomy and CTS pathophysiology as a foundation for exploring the diverse applications of US in CTS evaluation. B-mode US assessment is presented with a focus on cross-sectional imaging and dynamic evaluations, including the transverse translocation and longitudinal gliding of the median nerve. We also review current methods for assessing vascularization in CTS and explore the usefulness of elastography in CTS evaluation. The advantages and limitations of each US method are elucidated, highlighting their practical utility in clinical practice.
腕管综合征（CTS）是最常见的单神经病，由正中神经在纤维骨性腕管内受压引起。诊断通常基于临床评估，并通过神经传导研究确认。然而，超声（US）已成为 CTS 确认的一种有价值的无创辅助手段，与电诊断测试相比，在患者舒适度和诊断准确性方面具有潜在优势。本综述首先简要总结了腕管解剖结构和 CTS 病理生理学，为探讨 US 在 CTS 评估中的多种应用奠定了基础。重点介绍了 B 型 US 评估，包括正中神经的横截面积成像和动态评估，包括横向移位和纵向滑动。我们还回顾了目前评估 CTS 血管生成的方法，并探讨了弹性成像在 CTS 评估中的有用性。阐述了每种 US 方法的优缺点，突出了它们在临床实践中的实际应用价值。
