Korean J Neurotrauma.  2013 Apr;9(1):1-5. 10.13004/kjnt.2013.9.1.1.

The Diagnostic Value of Ultrasonography in Korean Carpal Tunnel Syndrome Patients

Affiliations
  • 1Department of Neurosurgery, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea. jwdohns@naver.com

Abstract


OBJECTIVE
The purpose of this study was to assess the diagnostic utility of the wrist ultrasonography (USG) in patients with and without carpal tunnel syndrome (CTS).
METHODS
Individuals with electrodiagnostically proven CTS patients and healthy control subjects were enrolled prospectively. USG was done 60 wrists of 48 patients with CTS and 36 wrists of 18 controls. The USG analysis included median nerve cross sectional area (CSA) at the level of carpal tunnel inlet. We also evaluated the relationship between median nerve CSA at the level of carpal tunnel inlet and severity grade of nerve conduction test in CTS patients.
RESULTS
The median nerve CSA at the level of carpal tunnel inlet was significantly larger in CTS patients (13.6 mm2 versus 7.7 mm2, p<0.0001). And there was an association between median nerve CSA and severity grade of nerve conduction studies (p=0.036). Receiver operating characteristics (ROC) analysis yielded sensitivity of 86.7% and specificity of 88.9% using a cut-off value of 9 mm2. But the specificity was increased to 97.2%, although sensitivity was decreased to 78.3%, when using cut-off value at 10.1 mm2.
CONCLUSION
Ultrasonographic measurement of the median nerve CSA at carpal tunnel inlet was useful in diagnosis of CTS. According to ROC analysis, USG is used as a complementary test for electrodiagnostic test.

Keyword

Carpal tunnel syndrome; Ultrasonography; Electrodiagnosis

MeSH Terms

Bays
Carpal Tunnel Syndrome
Electrodiagnosis
Humans
Median Nerve
Neural Conduction
Prospective Studies
ROC Curve
Sensitivity and Specificity
Wrist

Figure

  • FIGURE 1. Receiver operating characteristics curve for ultrasonographic assessments of median nerve cross-sectional area at carpal tunnel inlet. The area under the curve is 0.935 (95% confidence interval, 0.86–0.98; p<0.0001).

  • FIGURE 2. Box plot showing median nerve cross-sectional area (CSA) according to severity of nerve conduction study, and control subjects.


Reference

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