Yagobian Shiva D, Wallace Sean R, Fowler John R
University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA, 15213, USA.
Department of Orthopaedics, University of Pittsburgh Medical Center, Suite 1010, Kaufmann Building, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA.
J Hand Microsurg. 2024 Sep 16;16(5):100159. doi: 10.1016/j.jham.2024.100159. eCollection 2024 Dec.
Carpal tunnel syndrome (CTS) is responsible for over 90 % of median nerve neuropathies. Though a clinical diagnosis, evaluation of nerve conduction via electrodiagnostic studies (EDX) and median nerve cross sectional area (CSA) through sonographic imaging provides supporting evidence and insight into disease severity. The advent of handheld ultrasound devices offers a portable, cost-effective and non-invasive method for median nerve assessment, yet its accuracy compared to traditional cart-based ultrasound has not been assessed in this setting.
43 consecutive patients who presented to an outpatient orthopedic clinic within a large academic institution for symptoms consistent with CTS between August 2023 and April 2024 were included. Handheld sonography was performed with the Clarius Convex L20 HD3 8-20 MHz transducer. The GE Venue Go with a 4-20 MHz linear transducer was used for conventional cart-based ultrasound evaluation. A paired -test was performed to compare the mean cross-sectional area (CSA) measured with the GE machine to the mean CSA measured with the Clarius transducer (p < 0.05).
The average CSA measurement obtained with the GE was 14.21 ± 4.89 mm. The average CSA measurement obtained with the Clarius handheld transducer was 13.54 ± 4.50 mm. The mean difference between the GE and Clarius groups was 0.62 mm (95 % CI = -1.47 to 2.71), p = 0.55.
CSA measurements of the median nerve obtained by a handheld ultrasound transducer are comparable to those measured by a traditional cart-based ultrasound machine for carpal tunnel diagnosis. The adoption of handheld ultrasounds in clinical settings holds the potential for quicker, more precise diagnoses and broader access to imaging.
腕管综合征（CTS）占正中神经病变的90%以上。虽然是临床诊断，但通过电诊断研究（EDX）评估神经传导以及通过超声成像评估正中神经横截面积（CSA）可为疾病严重程度提供支持证据和深入了解。手持式超声设备的出现为正中神经评估提供了一种便携、经济高效且非侵入性的方法，但在这种情况下，其与传统推车式超声相比的准确性尚未得到评估。
纳入了2023年8月至2024年4月期间在一家大型学术机构的门诊骨科诊所就诊、症状符合CTS的43例连续患者。使用Clarius凸阵L20 HD3 8 - 20MHz探头进行手持式超声检查。使用配备4 - 20MHz线性探头的GE Venue Go进行传统的推车式超声评估。进行配对t检验，以比较用GE机器测量的平均横截面积（CSA）与用Clarius探头测量的平均CSA（p < 0.05）。
GE测得的平均CSA为14.21±4.89mm。Clarius手持式探头测得的平均CSA为13.54±4.50mm。GE组和Clarius组之间的平均差异为0.62mm（95%CI = -1.47至2.71），p = 0.55。
手持式超声探头获得的正中神经CSA测量值与传统推车式超声机器测量的用于腕管诊断的值相当。在临床环境中采用手持式超声有可能实现更快、更精确的诊断，并更广泛地获得成像检查。
