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首页> 外文期刊>Neurological sciences >The controversy of the normal values of ultrasonography in carpal tunnel syndrome: diagnostic accuracy of wrist-dependent CSA revisited
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The controversy of the normal values of ultrasonography in carpal tunnel syndrome: diagnostic accuracy of wrist-dependent CSA revisited

机译：超声检查在腕管综合征中的正常值争议：依赖依赖CSA的诊断准确性重新审视

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IntroductionNo consensus exists about the upper limit of normal (ULN) of the cross-sectional area (CSA) of the median nerve in diagnosing carpal tunnel syndrome (CTS). Previously, we demonstrated a strong positive correlation between wrist circumference and CSA. ULN depending on wrist circumference turned out to have a low sensitivity, which was hypothesized to be caused by an age mismatch. The aim of this study was to re-evaluate the found invariance by augmentation of the healthy control group, adding older subjects, and to determine the diagnostic accuracy of the updated normal values.MethodsCSA and wrist circumference were measured in an additional 42 healthy controls in the ages of 40-60. Univariable and multivariable linear regression analyses were applied to determine predicting factors for CSA. Diagnostic accuracy was assessed in a prospective cohort of 253 patients.ResultsA strong correlation was found between wrist circumference and CSA (r=0.61). Wrist circumference is the most important independent predictor for ULN (r(2)=0.37). We managed to simplify our newly derived regression equations, which turned out to be unrelated to age. Sensitivity of our new equations is low, but higher than a general fixed cut-off value (53.4% and 47.4%, respectively).DiscussionWrist circumference is the most important independent predicting factor of CSA. By using our updated equations and taking wrist circumference into account, one can determine a more precise ULN for each individual, which will lead to the improvement of the diagnostic accuracy of ultrasonography (US). Sensitivity for US in diagnosing CTS remains low and it can therefore not replace EDX.
机译：诊断腕管综合征（CTS）中位神经横截面积（CSA）的正常（ULN）的上限存在概要。以前，我们展示了腕围和CSA之间的强烈正相关。根据腕圆周的uln，敏感性低灵敏度，这是由年龄不匹配引起的。本研究的目的是通过增强健康对照组，添加较旧的受试者并确定更新的正常值的诊断准确性。在额外的42个健康对照中测量了更​​新的正常值的诊断准确性。年龄在40-60岁。应用了不可变量和多变量的线性回归分析来确定CSA的预测因素。在预期队列中评估了诊断准确性253名患者。腕围和CSA之间发现了强烈的相关性（r = 0.61）。腕围是ULN最重要的独立预测因子（R（2）= 0.37）。我们设法简化了新派生的回归方程，结果结果与年龄无关。我们的新方程的敏感性低，但高于一般固定的截止值（分别为53.4％和47.4％）.discussionwrist圆周是CSA最重要的独立预测因子。通过使用我们更新的方程和考虑腕表，可以为每个人确定更精确的ULN，这将导致超声检查（US）的诊断准确性的提高。对我们诊断CTS的灵敏度仍然很低，因此它不能取代EDX。

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