High Frequency Ultrasound Assessment Of The Severity Of Carpal Tunnel Syndrome

ObjectiveTo investigate the diagnostic value of high-frequency ultrasound measurement of median nerve cross-sectional area(CSA)for carpal tunnel syndrome(CTS);to explore the role of high-frequency ultrasound CSA measurement in CTS severity classification;to explore the measurement of correlation between ulnar nerve conduction(NCS)and CTS;the value of median nerve CSA in judging the severity of severe CTS.MethodsA total of 62 patients were included in the study.The control group included 17 patients,9 females and 8 males.The study included a total of 113 wrists,female: male = 87:26,grouped according to the results of electrophysiological examination and the number of wrists in each group,divided into normal group(n=34),mild group(n=39),medium group(n=37),severe group A(n=25),severe group B(n=13).Clinical Symptoms in the case group ranged from 1 month to 5 years.The percentage of patients who were positive in the Phalen test and the Tinel test in the case group were 61.3% and 77.4%.All patients enrolled in the study were Primary carpal tunnel syndrome.The case group was a CTS patient who met the short-listed criteria.All patients underwent physical examination,height and weight measurement,cervical X-ray,electrophysiology,ultrasonography.Electrophysiological examination and ultrasound are examined at the same time.According to the results of electrophysiological examination,the CSA at the entrance of the carpal tunnel was measured by 18 Hz high-frequency ultrasound examination,and the age and BMI of each group were recorded.The continuous variable data of each group were used as " (?)±s".;according to two independent sample T tests,normal and mild,mild and moderate,moderate and severe A,severe A and B in age,BMI,median nerve CSA,median nerve and ulnar nerve Statistical difference between sensory nerve latency and sensory nerve conduction velocity;Pearson correlation coefficient was used to evaluate the correlation between median nerve CSA and study variables;CSA was drawn according to each group ultrasound measurement at the entrance of the median nerve carpal tunnel.In Person correlation analysis,CSA was positively correlated with severity,age,BMI,and median nerve sensory nerve latency(r=0.918,P=0.000;r=0.421,P=0.000;r=0.563,P=0.000;r= 0.734 P=0.000);CSA was negatively correlated with median nerve sensory nerve conduction velocity and ulnar nerve sensory latency(r =-0.695,P=0.000;r =-0.340,P=0.000);CSA and ulnar nerve sensory conduction velocity were no correlation(P=0.585).ConclusionsHigh-frequency ultrasound measurements of the median nerve CSA can reflect the severity of median nerve involvement and provide an image of median nerve injury swelling and its surrounding anatomy.High-frequency ultrasound is an effective method of diagnosing the severity of CTS and can guide CTS treatment.1.The neurophysiological damage of CTS has a significant relationship with the CSA of the median nerve: the more severe the patient’s condition,the larger the cross-sectional area of the median nerve.Ultrasound can be used for the diagnosis of CTS,and its severity can be staged according to the measured value of the carpal tunnel inlet CSA;2.There is no correlation between the measured value of the ulnar NCS and the severity of the CTS condition;3.Patients who have CTS with SNAP and CMAP deficiency,ultrasonography plays an important role in judging their severity.