Does the ratio of the carpal tunnel inlet and outlet cross-sectional areas in the median nerve reflect carpal tunnel syndrome severity?

作     者：Li Zhang Aierken Rehemutula Feng Peng Cong Yu Tian-bin Wang Lin Chen 

作者机构：Department of Hand Surgery Huashan Hospital Fudan University Key Laboratory of Hand Reconstruction Ministry of Health Shanghai Key Laboratory of Peripheral Nerve and Microsurgery Department of Orthopedics Beijing University People’s Hospital 

出 版 物：《Neural Regeneration Research》 (中国神经再生研究（英文版）)

年 卷 期：2015年第10卷第7期

页      面：1172-1176页

核心收录：

学科分类：0710[理学-生物学] 1002[医学-临床医学] 1001[医学-基础医学(可授医学、理学学位)] 10[医学] 

基　　金：supported by a grant from the Shanghai Key Laboratory of Peripheral Nerve and Microsurgery in China,No.14DZ2273300 the Natural Science Foundation of Shanghai in China,No.13ZR1404600 a grant from the National Key Basic Research Program of China(973 Program),No.2014CB542201 

主　　题：nerve regeneration peripheral nerve injury ultrasonography carpal tunnel syndrome diagnosis cross sectional area classification clinical laboratory technique electrodiagnosis median nerve 973 Program neural regeneration 

摘      要：Although ultrasound measurements have been used in previous studies on carpal tunnel syndrome to visualize injury to the median nerve, whether such ultrasound data can indicate the severity of carpal tunnel syndrome remains controversial. The cross-sectional areas of the median nerve at the tunnel inlet and outlet can show swelling and compression of the nerve at the carpal. We hypothesized that the ratio of the cross-sectional areas of the median nerve at the carpal tunnel inlet to outlet accurately reflects the severity of carpal tunnel syndrome. To test this, high-resolution ultrasound with a linear array transducer at 5–17 MHz was used to assess 77 patients with carpal tunnel syndrome. The results showed that the cut-off point for the inlet-to-outlet ratio was 1.14. Significant differences in the inlet-to-outlet ratio were found among patients with mild, moderate, and severe carpal tunnel syndrome. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.29 between mild and more severe（moderate and severe） carpal tunnel syndrome patients with 64.7% sensitivity and 72.7% specificity. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.52 between the moderate and severe carpal tunnel syndrome patients with 80.0% sensitivity and 64.7% specificity. These results suggest that the inlet-to-outlet ratio reflected the severity of carpal tunnel syndrome.