摘要
Abstract
Objective To investigate the correlation and diagnostic value of median nerve cross-sectional area(CSA)measured by musculoskeletal ultrasound and nerve conduction velocity(NCV)for grading the severity of carpal tunnel syndrome(CTS).Methods A single-center,cross-sectional study of diagnostic accuracy and correlation was conducted.A total of 120 patients(184 wrists)with clinically suspected CTS admitted between January 2023 and December 2025 were enrolled.All patients underwent high-frequency musculoskeletal ultrasound(measuring median nerve CSA at the carpal tunnel inlet)and nerve conduction studies[distal motor latency(DML),sensory nerve conduction velocity(SCV),and compound muscle action potential amplitude(CMAP)].Using neuroelectrophysiological findings as the independent reference standard,the wrists with confirmed CTS were classified according to grading criteria into mild(56 wrists),moderate(68 wrists),and severe(60 wrists)groups.One-way analysis of variance and Spearman rank correlation analysis were used to analyze the correlations of CSA and NCV with CTS severity,and receiver operating characteristic curve analysis was used to evaluate the discrimi-native performance of CSA for severe CTS.Results The median nerve CSA values in the mild,moderate,and severe CTS groups were(12.35±2.11)mm2,(15.68±2.43)mm2,and(20.57±3.02)mm2,respec-tively,with statistically significant differences among the three groups(P<0.001).The SCV values were(44.21±3.56)m/s,(36.84±4.12)m/s,and(28.93±5.07)m/s,respectively,with statistically significant differences among groups(P<0.001).The DML values were(3.68±0.54)ms,(5.21±0.78)ms,and(7.36±1.25)ms,and the CMAP values were(9.12±1.85)mV,(6.85±1.63)mV,and(3.47±1.12)mV,respectively,with statistically significant differences in both DML and CMAP among the three groups(all P<0.001).Spearman correlation analysis showed that CSA was significantly positively correlated with CTS severity(r=0.862,95%CI:0.812-0.900,P<0.001),while SCV was significantly negatively correlated with CTS severity(r=-0.841,95%CI:-0.884--0.787,P<0.001).CSA was significantly positively correlated with DML(r=0.794,95%CI:0.725-0.850,P<0.001)and significantly negatively correlated with CMAP(r=-0.756,95%CI:-0.820--0.678,P<0.001).Using severe CTS as the refer-ence standard,the area under the ROC curve for CSA was 0.932(95%CI:0.895-0.970,P<0.001).The optimal diagnostic cutoff was 17.82 mm2,with a sensitivity of 90.00%and a specificity of 85.48%.Conclusion The median nerve CSA measured by musculoskeletal ultrasound is significantly negatively correlated with nerve conduction velocity,and CSA increases significantly with higher CTS severity grad-ing.When CSA exceeds 17.82 mm2,it demonstrates high discriminative efficacy for severe CTS.Ultra-sound measurement can serve as an effective complement to neuroelectrophysiological testing for grading CTS severity.关键词
腕管综合征/肌骨超声/正中神经/横截面积/神经传导速度/疾病严重程度Key words
carpal tunnel syndrome/musculoskeletal ultrasound/median nerve/cross-sectional area/nerve conduction velocity/disease severity分类
医药卫生
