Carpal tunnel syndrome: elastosonographic strain ratio andcross-sectional area evaluation for the diagnosis and disease severity.

Abstract

Aim: To evaluate the role of gray scale ultrasonography (US) and real time elastosonography (RTE) in carpal tunnel syndrome (CTS). Materials and methods: Both wrists of 18 healthy volunteers (n=36) formed the control group (Group 1) and 19 symptomatic outpatients of the neurology clinic constituted the patient group. According to nerve conduction study results, cases with mild CTS (n=15) formed Group 2; cases with moderate to severe CTS (n=20) formed Group 3. Cross sectional area (CSA) and strain ratio (SR) were measured at carpal tunnel inlet (CTI) and 4 cm proximal to the distal end of the radius (P). CSA and SR change score (CSA CTI -CSA P ; SR CTI -SR P ), CSA and SR ratio score (CSA CTI / CSA P ; SR CTI / SR P ) were calculated.

Shear Wave and Strain Elastographic Features of the Brachial Plexus in Healthy Adults: Reliability of the Findings—a Pilot Study

“…Ultrasound imaging is a beneficial and effective method for describing and analyzing the course of the brachial plexus and can guide therapeutic interventions . Sonoelastography is a sophisticated US technique that can detect tissue stiffness in vivo and can be helpful in the diagnosis of neuropathies . In this study, we showed that the brachial plexus in healthy individuals had intermediate stiffness with poor to moderate interobserver agreement and no correlation with age or sex.…”

“…Due to the lack of any previous study evaluating brachial plexus elasticity, we could not compare our SWE and SE findings with the literature. There were a few studies on peripheral nerve elasticity, which were mostly about the median nerve in carpal tunnel syndrome (CTS) on either SWE or SE with different US machines . Kantarci et al compared the elastic modulus of the median nerve in patients with and without CTS on the longitudinal axis and found that the median nerve was stiffer in the CTS group (66.7 ± 26.5 kPa in the CTS group and 32.0 ± 8.4 kPa in the control group).…”

“…Ghajarzadeh et al compared SE images of the median nerve in CTS and control groups by using color indices and found that median nerve was stiffer in CTS. Tatar et al evaluated the median nerve in CTS by SE on the transverse axis and found a mean strain ratio of 1.85 ± 0.65 in the control group. Our SWE and strain ratio values were lower than the reported values for the healthy median nerve.…”

“…Shear wave elastography can allow visualization and documentation of absolute stiffness in kilopascals or meters per second objectively without a maneuver . Sonoelastography of peripheral nerves in patients with trapped neuropathies has been investigated and compared with healthy individuals by using either SWE or SE . As far as we know, however, no study on the reliability of sonoelastography of the brachial plexus has been reported in the medical literature in English.…”

Reliability, Feasibility and Value of Ecography in Clinical-functional Results in Patients Affected by Carpal Tunnel Syndrome: is There a Correlation?

“…In patients evaluated, we found a correlation between the value of the CSA of the median nerve and the symptomatic and functional outcomes of the BCTQ with statistically significant p values. Many studies have in fact reported a correlation between the change in the CSA of the median nerve post-surgery and a reduction of the patient’s symptoms (12, 13, 14, 15, 16). …”