Aims and objectives
The use of ultrasound in the study of peripheral nervesdates back to the late 80s [1]; the first ultrasound studies of the median nerve (MN) affected by carpal tunnel syndrome (CTS) date back to the 90s [2].
Since then,
ultrasound has been increasingly used in the study of peripheral nerves becoming the main morphological examination to be combined with functional electrodiagnostic tests [3].
The MN,
due to the high prevalence of CTS,
is the most commonly studied nerve with ultrasound,
usingprobes with a frequency varying...
Methods and materials
To validate this new equipment,
we compared MN images of 10 healthy subjects obtained with VHRUS and HRUS.
We excluded from our sample subjects with bifid median nerve,
with CTS symptoms and diabetes.
The VHRUSequipment used in our study was Vevo MD (Visualsonics,
Toronto,
Canada) with a 70 MHz and 48 MHz linear array transducers.
The HRUSequipment used in our study was MyLab Gamma (Esote,
Genova,
Italia) with a 19 MHz linear array transducer.
In all our 10 healthy volunteers we obtained images of left...
Results
As regards the CSA values obtained at the carpal tunnel inlet,
we measured a median of 9.50 mm2 using the 19 MHz probe and a median of 10.12 mm2 using the 70 MHz probe (fig.
6 and 8).
The p-value,
calculated with the Wilcoxon test,
was 0.28 so that we can accept the hypothesis of significant equality of the medians of the two groups.
The median obtained using VHRUS is slightly higher than the median obtained using HRUS,
which indicates a slight underestimation by the...
Conclusion
Our results demonstrate that VHRUS is reliable in theMN ultrasonography as well as traditional HRUS and that both techniques can be effectively usedin clinical applications.
Although VHRUSand HRUS are equivalent in measuring the cross-sectional area and the perimeter of the MN,
VHRUSallows obtaininghigher resolution images with pixels of 30 and 50 microns by using 70 MHz and 48 MHz probes,
respectively.
Such a betterspatial resolution gave usa higher degree of confidence in identifying theMN and in precisely measuring the quantitative biometric data necessary for the...
Personal information
Saverio Vitali and Giacomo Aringhieri are researchers,
and Piercarlo Rossi is resident at the University Radiodiagnostic Unit 1 of the University of Pisa (Chairman Prof.
Davide Caramella).
Tommaso Bocci,
Davide Barloscio and Michela Santin are co-workers of Prof.
Ferdinando Sartucci (Associate Professor of Neurology,
University of Pisa).
References
1.
Fornage,
B.D.,
Peripheral nerves of the extremities: imaging with US.
Radiology,
1988.
167(1): p.
179-82.
2.
Buchberger,
W.,
et al.,
High-resolution ultrasonography of the carpal tunnel.
J Ultrasound Med,
1991.
10(10): p.
531-7.
3.
Cartwright,
M.S.,
et al.,
Evidence-based guideline: neuromuscular ultrasound for the diagnosis of carpal tunnel syndrome.
Muscle Nerve,
2012.
46(2): p.
287-93.
4.
Tai,
T.W.,
et al.,
Ultrasonography for diagnosing carpal tunnel syndrome: a meta-analysis of diagnostic test accuracy.
Ultrasound Med Biol,
2012.
38(7): p.
1121-8.
5.
Hobson-Webb,
L.D.,
et al.,...