Yıl: 2018 Cilt: 48 Sayı: 1 Sayfa Aralığı: 110 - 116 Metin Dili: İngilizce DOI: 10.3906/sag-1707-124 İndeks Tarihi: 18-06-2019

Diagnostic utility of the sonographic median to ulnar nerve cross-sectional area ratio in carpal tunnel syndrome

Öz:
Background/aim: The aim of this study was to assess the diagnostic utility of the ultrasonographic ratio of median nerve cross-sectionalarea (m-CSA) to ulnar nerve cross-sectional area (u-CSA), the m-CSA/u-CSA ratio, in carpal tunnel syndrome (CTS).Materials and methods: Fifty patients with positive symptoms and electromyography results of CTS and 50 healthy matched controlsubjects were evaluated. Ultrasonographic m-CSA and u-CSA measurements of each participant were made at the level of the pisiformbone and the m-CSA/u-CSA ratio was calculated.Results: Using the m-CSA cut-off value of 11.95 mm2 showed a sensitivity of 80% and a specificity of 80% while using a cut-off value2.95 for the ratio of m-CSA/u-CSA showed a sensitivity of 86% and a specificity of 72% in the diagnosis of CTS.Conclusion: The ratio of m-CSA/u-CSA at the level of the pisiform bone was not detected to be superior to m-CSA in the diagnosis ofCTS.
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Preston DC, Shapiro BE. Electromyography and Neuromuscular Disorders: Clinical-Electrophysiological Correlations. 2nd ed. Philadelphia, PA, USA: Elsevier; 2005.
  • Werner RA, Andray M. Carpal tunnel syndrome: pathophysiology and clinical neurophysiology. Clin Neurophysiol 2002; 113: 1373-1381.
  • Jablecki CK, Andary MT, Floeter MK, Miller RG, Quartly CA, Vennix MJ, Wilson JR; American Association of Electrodiagnostic Medicine; American Academy of Neurology; American Academy of Physical Medicine and Rehabilitation. Practice parameter: electrodiagnostic studies in carpal tunnel syndrome. Report of the American Association of Electrodiagnostic Medicine, American Academy of Neurology, and the American Academy of Physical Medicine and Rehabilitation. Neurology 2002; 58: 1589-1592.
  • Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, Caliandro P, Hobson-Webb LD. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol 2016; 15: 1273-1284.
  • Tagliafico A, Bignotti B, Martinoli C. Update on ultrasoundguided interventional procedures on peripheral nerves. Semin Musculoskelet Radiol 2016; 20: 453-460.
  • Tagliafico A, Bignotti B. New parameters for evaluating peripheral nerve disorders on sonography and magnetic resonance imaging. J Ultrasound Med 2015; 34: 1523.
  • Tagliafico AS. Peripheral nerve imaging: not only crosssectional area. World J Radiol 2016; 8: 726-728.
  • McDonagh C, Alexander M, Kane D. The role of ultrasound in the diagnosis and management of carpal tunnel syndrome: a new paradigm. Rheumatology (Oxford) 2015; 54: 9-19.
  • Wiesler ER, Chloros GD, Cartwright MS, Smith BP, Rushing J, Walker FO. The use of diagnostic ultrasound in carpal tunnel syndrome. J Hand Surg Am 2006; 31: 726-732.
  • Bathala L, Kumar P, Kumar K, Shaik A, Visser LH. Normal values of median nerve cross-sectional area obtained by ultrasound along its course in the arm with electrophysiological correlations, in 100 Asian subjects. Muscle Nerve 2014; 49: 284-286.
  • Qrimli M, Ebadi H, Breiner A, Siddiqui H, Alabdali M, Abraham A, Lovblom LE, Perkins BA, Bril V. Reference values for ultrasonography of peripheral nerves. Muscle Nerve 2016; 53: 538-544.
  • Won SJ, Kim BJ, Park KS, Yoon JS, Choi H. Reference values for nerve ultrasonography in the upper extremity. Muscle Nerve 2013; 47: 864-871.
  • Cartwright MS, Passmore LV, Yoon JS, Brown ME, Caress JB, Walker FO. Cross-sectional area reference values for nerve ultrasonography. Muscle Nerve 2008; 37: 566-571.
  • Kim HS, Joo SH, Cho HK, Kim YW. Comparison of proximal and distal cross-sectional areas of the median nerve, carpal tunnel, and nerve/tunnel index in subjects with carpal tunnel syndrome. Arch Phys Med Rehabil 2013; 94: 2151-2156.
  • Leite JC, Jerosch-Herold C, Song F. A systematic review of the psychometric properties of the Boston Carpal Tunnel Questionnaire. BMC Musculoskelet Disord 2006; 7: 78.
  • Sezgin M, Incel NA, Serhan S, Camdeviren H, As I, Erdoğan C. Assessment of symptom severity and functional status in patients with carpal tunnel syndrome: reliability and functionality of the Turkish version of the Boston Questionnaire. Disabil Rehabil 2006; 28: 1281-1286.
  • Padua L, Padua R, Aprile I, Pasqualetti P, Tonali P; Italian CTS Study Group. Multiperspective follow-up of untreated carpal tunnel syndrome: a multicenter study. Neurology 2001; 56: 1459-1466.
  • Ulaşli AM, Duymuş M, Nacir B, Erdem HR, Koşar U. Reasons for using swelling ratio in sonographic diagnosis of carpal tunnel syndrome and a reliable method for its calculation. Muscle Nerve 2013; 47: 396-402.
  • Hobson-Webb LD, Massey JM, Juel VC, Sanders DB. The ultrasonographic wrist-to-forearm median nerve area ratio in carpal tunnel syndrome. Clin Neurophysiol 2008; 119: 1353- 1357.
  • Klauser AS, Abd Ellah MM, Halpern EJ, Siedentopf C, Auer T, Eberle G, Bellmann-Weiler R, Kremser C, Sojer M, Löscher WN et al. Sonographic cross-sectional area measurement in carpal tunnel syndrome patients: can delta and ratio calculations predict severity compared to nerve conduction studies? Eur Radiol 2015; 25: 2419-2427.
  • Abrishamchi F, Zaki B, Basiri K, Ghasemi M, Mohaghegh M. A comparison of the ultrasonographic median nerve crosssectional area at the wrist and the wrist-to-forearm ratio in carpal tunnel syndrome. J Res Med Sci 2014; 19: 1113-1117.
  • Kim HS, Joo SH, Han ZA, Kim YW. The nerve/tunnel index: a new diagnostic standard for carpal tunnel syndrome using sonography: a pilot study. J Ultrasound Med 2012; 31: 23-29.
  • Tagliafico A, Martinoli C. Reliability of side-to-side sonographic cross-sectional area measurements of upper extremity nerves in healthy volunteers. J Ultrasound Med 2013; 32: 457-462.
  • Eom YI, Choi MH, Kim YK, Joo IS. Sonographic findings in the ulnar nerve according to the electrophysiologic stage of carpal tunnel syndrome. J Ultrasound Med 2015; 34: 1027- 1034.
  • Yurdakul OV, Mesci N, Çetinkaya Y, Geler Külcü D. Diagnostic significance of ultrasonographic measurements and median-ulnar ratio in carpal tunnel syndrome: correlation with nerve conduction studies. J Clin Neurol 2016; 12: 289- 294.
APA ATAN T, günendi z (2018). Diagnostic utility of the sonographic median to ulnar nerve cross-sectional area ratio in carpal tunnel syndrome. , 110 - 116. 10.3906/sag-1707-124
Chicago ATAN Tuğba,günendi zafer Diagnostic utility of the sonographic median to ulnar nerve cross-sectional area ratio in carpal tunnel syndrome. (2018): 110 - 116. 10.3906/sag-1707-124
MLA ATAN Tuğba,günendi zafer Diagnostic utility of the sonographic median to ulnar nerve cross-sectional area ratio in carpal tunnel syndrome. , 2018, ss.110 - 116. 10.3906/sag-1707-124
AMA ATAN T,günendi z Diagnostic utility of the sonographic median to ulnar nerve cross-sectional area ratio in carpal tunnel syndrome. . 2018; 110 - 116. 10.3906/sag-1707-124
Vancouver ATAN T,günendi z Diagnostic utility of the sonographic median to ulnar nerve cross-sectional area ratio in carpal tunnel syndrome. . 2018; 110 - 116. 10.3906/sag-1707-124
IEEE ATAN T,günendi z "Diagnostic utility of the sonographic median to ulnar nerve cross-sectional area ratio in carpal tunnel syndrome." , ss.110 - 116, 2018. 10.3906/sag-1707-124
ISNAD ATAN, Tuğba - günendi, zafer. "Diagnostic utility of the sonographic median to ulnar nerve cross-sectional area ratio in carpal tunnel syndrome". (2018), 110-116. https://doi.org/10.3906/sag-1707-124
APA ATAN T, günendi z (2018). Diagnostic utility of the sonographic median to ulnar nerve cross-sectional area ratio in carpal tunnel syndrome. Turkish Journal of Medical Sciences, 48(1), 110 - 116. 10.3906/sag-1707-124
Chicago ATAN Tuğba,günendi zafer Diagnostic utility of the sonographic median to ulnar nerve cross-sectional area ratio in carpal tunnel syndrome. Turkish Journal of Medical Sciences 48, no.1 (2018): 110 - 116. 10.3906/sag-1707-124
MLA ATAN Tuğba,günendi zafer Diagnostic utility of the sonographic median to ulnar nerve cross-sectional area ratio in carpal tunnel syndrome. Turkish Journal of Medical Sciences, vol.48, no.1, 2018, ss.110 - 116. 10.3906/sag-1707-124
AMA ATAN T,günendi z Diagnostic utility of the sonographic median to ulnar nerve cross-sectional area ratio in carpal tunnel syndrome. Turkish Journal of Medical Sciences. 2018; 48(1): 110 - 116. 10.3906/sag-1707-124
Vancouver ATAN T,günendi z Diagnostic utility of the sonographic median to ulnar nerve cross-sectional area ratio in carpal tunnel syndrome. Turkish Journal of Medical Sciences. 2018; 48(1): 110 - 116. 10.3906/sag-1707-124
IEEE ATAN T,günendi z "Diagnostic utility of the sonographic median to ulnar nerve cross-sectional area ratio in carpal tunnel syndrome." Turkish Journal of Medical Sciences, 48, ss.110 - 116, 2018. 10.3906/sag-1707-124
ISNAD ATAN, Tuğba - günendi, zafer. "Diagnostic utility of the sonographic median to ulnar nerve cross-sectional area ratio in carpal tunnel syndrome". Turkish Journal of Medical Sciences 48/1 (2018), 110-116. https://doi.org/10.3906/sag-1707-124