Value of superb microvascular imaging ultrasonography in the diagnosis of carpal tunnel syndrome: Compared with color Doppler and power Doppler

Jie Chen, Li Chen, Lei Wu, Rui Wang, Ji-Bin Liu, Bing Hu, Li-Xin Jiang, Jie Chen, Li Chen, Lei Wu, Rui Wang, Ji-Bin Liu, Bing Hu, Li-Xin Jiang

Abstract

The aim of this study was to compare the value of superb microvascular imaging (SMI) in carpal tunnel syndrome (CTS) with that of color Doppler ultrasonography (CDUS) and power Doppler ultrasonography (PDUS).Fifty patients with symptomatic CTS and 25 healthy volunteers were enrolled. The cross-sectional area (CSA), CDUS score, PDUS score, and SMI score of the median nerve (MN) at the carpal tunnel were recorded. The value of different ultrasonography (US) diagnostic strategies was calculated.The blood flow display ratio in the MN of the healthy volunteers had no statistical difference between CDUS, PDUS, and SMI (20%, 32%, and 48%, respectively, P >.05). The blood flow display ratio for SMI in patients was significantly higher than that of CDUS and PDUS (90%, 52%, and 60%, respectively, P <.005). The accuracy of SMI score ≥2 (79%) was much higher than that of CDUS and PDUS (61% and 63%, respectively, P <.05). Comprehensive consideration of SMI and CSA, CSA≥10.5 mm, and/or SMI score ≥2 has the highest accuracy (83%), significantly higher than that of CSA combination with CDUS or PDUS (68% and 69%, respectively, P <.05).SMI is more sensitive to display the blood flow in the MN with CTS than CDUS and PDUS. It might significantly improve the diagnosis value for CTS.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
SMI score for the MN. (A) 0 score, no blood flow detected within MN; (B) 1 score, 2 spot blood flow within MN; (C) 2 score, more than 2 spot blood flow within MN; (D) 3 score, more than 2 strip blood flow within MN. MN = median nerve, SMI = superb microvascular imaging.
Figure 2
Figure 2
Flowchart of participants selection.
Figure 3
Figure 3
Ultrasound images of the MN at the same level from a 65-year-old female CTS patient, which shows score 1 by CDUS, score 2 by PDUS, and score 3 by SMI. CDUS = color Doppler ultrasonography, CTS = carpal tunnel syndrome, PDUS = power Doppler ultrasonography, SMI = superb microvascular imaging.
Figure 4
Figure 4
ROC curve of CSA at the distal wrist crease. CSA = cross-sectional area, ROC = receiver operating characteristic.

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Source: PubMed

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