Neural Regeneration Research ›› 2015, Vol. 10 ›› Issue (7): 1172-1176.doi: :10.4103/1673-5374.160117

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

Li Zhang 1, 2, 3, Aierken Rehemutula 1, 2, 3, Feng Peng 1, 2, 3,  Cong Yu 1, 2, 3, Tian-bin Wang 4, Lin Chen 1, 2, 3   

  1. 1 Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
    2 Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
    3 Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
    4 Department of Orthopedics, Beijing University People’s Hospital, Beijing, China
  • Received:2015-04-06 Online:2015-07-24 Published:2015-07-24
  • Contact: Feng Peng, M.D., peng_f@163.com.
  • Supported by:

     This study was 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; and a grant from the National Key Basic Research Program of China (973 Program), No. 2014CB542201.

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Abstract:

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.

Key words: nerve regeneration, peripheral nerve injury, ultrasonography, carpal tunnel syndrome, diagnosis, cross-sectional area, classification, clinical laboratory technique, electrodiagnosis, median nerve, 973 Program, neural regeneration