Background: Ultrasound (US) measurement of cross-sectional area (CSA) of the median nerve has emerged as a viable alternative to electromyography/nerve conduction studies (EMG/NCS) for diagnosis of carpal tunnel syndrome (CTS). The purpose of this study is to compare CSA of the median nerve between US and MRI using current MRI and US technology. The null hypothesis is there is no difference between US and MRI CSA measurements. Methods: The study design was an observational cohort, enrolling patients presenting to clinic with MRI of the wrist. Participants with clinical signs and symptoms of CTS were excluded. The CSA measurements of the median nerve on MRI T1-weighted axial images were performed by a hand fellow blinded to results of US measurements, and US measurement of median nerve CSA was performed by a hand fellowship trained surgeon blinded to results of the MRI measurements. Results were analyzed via percent error, Pearson correlation, and t tests. Results: Twenty participants were enrolled with mean age of 29.4 years. Four left wrists and 16 right wrists were measured. The US mean CSA of the median nerve was 6.8 mm2 (±2.330 mm2). The MRI mean CSA of the median nerve was 6.8 mm2 (±2.153 mm2), P = .442. Pearson correlation between modalities was 0.93, suggesting near-perfect correlation. Mean percent error was 8.8%. Conclusions: Results of this study suggest that US is an accurate method to measure CSA of the median nerve at the carpal tunnel inlet. The mean difference between US and MRI was unlikely to be clinically significant.
Keywords: MRI; carpal tunnel; median nerve; ultrasound; wrist.
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Cross-sectional Area of the Median Nerve at the Wrist: Comparison of Sonographic, MRI, and Cadaveric MeasurementsRKL Lee et al. J Clin Ultrasound 47 (3), 122-127. PMID 30597562.Median nerve CSA measurements by MRI are larger than US measurements and correlated better with cadaveric measurements. Median nerve CSA criteria used for diagnosing CTS …
Dexamethasone Versus Hyaluronidase as an Adjuvant to Local Anesthetics in the Ultrasound-guided Hydrodissection of the Median Nerve for the Treatment of Carpal Tunnel Syndrome PatientsMA Alsaeid. Anesth Essays Res 13 (3), 417-422. PMID 31602055.In this study, it was concluded that MN hydrodissction using hyaluronidase (as an adhesolysis agent) significantly improved patients with mild to moderate CTS compared to …
Ultrasonography Findings in Severe Carpal Tunnel SyndromeG Nkrumah et al. Hand (N Y) 15 (1), 64-68. PMID 30027757.Background: Increasing severity of carpal tunnel syndrome (CTS), as graded by nerve conduction studies (NCS), has been demonstrated to predict the speed and comple …
Diagnostic Utility of Ultrasonography Versus Nerve Conduction Studies in Mild Carpal Tunnel SyndromeM Mondelli et al. Arthritis Rheum 59 (3), 357-66. PMID 18311762. - ReviewIn mild cases of CTS, US did not detect more anomalies than NCV and vice versa, and no anomalies were detected with either diagnostic instrument in 23.5% of mild cases. …
Grey-scale Sonography and Sonoelastography for Diagnosing Carpal Tunnel SyndromeH Miyamoto et al. World J Radiol 8 (3), 281-7. PMID 27027498. - ReviewCarpal tunnel syndrome (CTS) is a common peripheral entrapment neuropathy of the median nerve at wrist level, and is thought to be caused by compression of the median ner …
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The Prognostic Value of Median Nerve Thickness in Diagnosing Carpal Tunnel Syndrome Using Magnetic Resonance Imaging: A Pilot StudyS Lee et al. Korean J Pain 33 (1), 54-59. PMID 31888318.Even though both MNCSA and MNT were significantly associated with CTS, MNT was identified as a more suitable measurement parameter.