Classifying median nerves in carpal tunnel syndrome: Ultrasound image analysis

Obuchowicz, Rafał; Kruszyńska, Julia; Strzelecki, Michał

doi:10.1016/j.bbe.2021.02.011

Cited by 18 publications

(12 citation statements)

References 83 publications

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“…Prior confirmation of these findings is useful in selecting a treatment. However, device/examiner dependency on the visualization of peripheral nerves is a limitation of this technique [ 10 , 11 ]. Furthermore, swelling of the median nerve is difficult to detect in patients older than 80 years, regardless of their severity of CTS [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

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Clinical Relevance of Ultrasonographic and Electrophysiological Findings of the Median Nerve in Unilateral Carpal Tunnel Syndrome Patients

et al. 2022

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Few studies have compared the unaffected and affected sides in the same carpal tunnel syndrome (CTS) patients using ultrasonography and electrophysiological tests. We focused on unilateral idiopathic CTS patients to investigate whether clinical test results differ between the unaffected and affected sides. The bilateral wrist joints of 61 unilateral idiopathic CTS patients were evaluated. The median nerve cross-sectional area of ultrasound image, and latencies of the compound muscle action potential (CMAP) and sensory nerve action potential (SNAP) were measured. The values obtained were compared between the affected and unaffected sides. The diagnostic accuracies of each parameter were assessed, and cut-off values were defined. Significant differences were observed in all parameters between the affected and unaffected sides (p < 0.01). Area under the curve (AUC) values were 0.74, 0.88, and 0.73 for the cross-sectional area, CMAP distal latency, and SNAP distal latency, respectively. Cut-off values were 11.9 mm2, 5.1 ms, and 3.1 ms for the cross-sectional area, CMAP distal latency, and SNAP distal latency, respectively. The most reliable parameter that reflected clinical symptoms was the distal latency of CMAP. Cut-off values for each parameter are considered to be an index for the onset of the clinical symptoms of CTS.

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Section: Discussionmentioning

confidence: 99%

“…We may need to consider the differences of nerve size in the different levels of median nerve. In addition, automatic image analysis procedures have been reported recently [ 11 ]. The results of our manual measurement may need to compare the results with automatic analyzing procedure.…”

Section: Discussionmentioning

confidence: 99%

Clinical Relevance of Ultrasonographic and Electrophysiological Findings of the Median Nerve in Unilateral Carpal Tunnel Syndrome Patients

et al. 2022

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“…The analysis of the image textures obtained for 20 patients allowed us to draw statistically reliable conclusions. The concept of using texture features preservation worked well with much coarser images, such as ultrasound [38], collected from relatively small groups of patients In this study, we used a 1.5T scanner, which is perfectly adequate for most clinical applications; however, it would be an interesting repetition of the examinations for 3T MRI, which allows the analysis of texture parameters for more accurately imaged tissues by providing images with higher SNR. Indeed, research was performed only for the T2-weighted sequence.…”

Section: Discussionmentioning

confidence: 99%

Effect of Matrix Size Reduction on Textural Information in Clinical Magnetic Resonance Imaging

Strzelecki

Piórkowski

Obuchowicz

2022

JCM

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The selection of the matrix size is an important element of the magnetic resonance imaging (MRI) process, and has a significant impact on the acquired image quality. Signal to noise ratio, often used to assess MR image quality, has its limitations. Thus, for this purpose we propose a novel approach: the use of texture analysis as an index of the image quality that is sensitive for the change of matrix size. Image texture in biomedical images represents tissue and organ structures visualized via medical imaging modalities such as MRI. The correlation between texture parameters determined for the same tissues visualized in images acquired with different matrix sizes is analyzed to aid in the assessment of the selection of the optimal matrix size. T2-weighted coronal images of shoulders were acquired using five different matrix sizes while maintaining the same field of view; three regions of interest (bone, fat, and muscle) were considered. Lin’s correlation coefficients were calculated for all possible pairs of the 310-element texture feature vectors evaluated for each matrix. The obtained results are discussed considering the image noise and blurring effect visible in images acquired with smaller matrices. Taking these phenomena into account, recommendations for the selection of the matrix size used for the MRI imaging were proposed.

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“…In spite of the various limitations, US allows the clinician to lower the water content in the tissue and to diagnose nerve swelling. 3 Cross-sectional area (CSA) of the median nerve is one of the useful USG parameters, indicative of CTS. USG measured CSA has been the strongest predictor of CTS severity compared to other variables tested.…”

Section: Supporting Examinationmentioning

confidence: 99%

“…2 The median nerve gives innervation to the small muscles of the hand and sensory innervation to the fingers, which control the touch sensation and reflexes for the right motor function, especially the hand grip. 3 CTS is the most prevalent neuropathic entrapment in the upper extremity. 4 The symptoms are recognized by pain, numbness, and tingling in the median nerve's division in the hand.…”

Section: Introductionmentioning

confidence: 99%

Current diagnosis and management of carpal tunnel syndrome: A review

Hidayati¹,

Subadi²,

Fidiana³

et al. 2022

Anaesth. pain intensive care

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Carpal tunnel syndrome (CTS) is a condition when median nerve, located in the carpal tunnel, is being suppressed by the surrounding structure. In 1854, the first clinical narration of median nerve compression in a carpal tunnel was found. CTS causes pain, tingling, and weakness in the half ring finger, middle finger, index finger, and thumb. These complaints lead the patients to seek medical help by a visiting doctor. CTS has become the major cause of upper extremity chronic neuropathic pain. CTS affects women 3.6 times more than men. This would cause high costs in medical treatment, rehabilitation, work hours lost compensation, initial pension costs, and new worker training. This makes CTS as a major problem in the field of employment. Carpal tunnel syndrome occurs as a result of chronic repetitive forceful work and other risk factors such as sex, age, heredity, hormonal, and weight. Knowledge of the diagnosis and comprehensive management of CTS are important to the doctor. Recent management based on the newest guidelines are important for clinician knowledge update. Correct diagnosis will lead to appropriate management based on recent CTS guidelines, which in turn will improve the quality of life for patients with CTS. This article will comprehensively discuss the diagnosis and recent management. Abbreviations: CTS - Carpal tunnel syndrome; NHIS - National Health Interview Study; EDX - Electrodiagnostic studies; SCT - Scratch Collapse Test; CSA - Cross-sectional area; PRP - Platelet-rich plasma; LLLT - Low-Level Laser Therapy; US – Ultrasound; DN - Dry needling; ECTR - Endoscopic carpal tunnel release; PDI - perineural dextrose injection; BCTQ - Boston Carpal Tunnel Questionnaire Key word: Carpal tunnel syndrome (CTS); neuropathy; pain; numbness; safe working environment; human; disease Citation: Hidayati HB, Subadi I, Fidiana, Puspamaniar VA. Current diagnosis and management of carpal tunnel syndrome: A review. Anaesth. pain intensive care 2022;26(3):394-404. DOI: 10.35975/apic.v26i3.1902 Received: August 16, 2021; Reviewed: April 24, 2022; Accepted: April 28, 2022

show abstract

Classifying median nerves in carpal tunnel syndrome: Ultrasound image analysis

Cited by 18 publications

References 83 publications

Clinical Relevance of Ultrasonographic and Electrophysiological Findings of the Median Nerve in Unilateral Carpal Tunnel Syndrome Patients

Clinical Relevance of Ultrasonographic and Electrophysiological Findings of the Median Nerve in Unilateral Carpal Tunnel Syndrome Patients

Effect of Matrix Size Reduction on Textural Information in Clinical Magnetic Resonance Imaging

Current diagnosis and management of carpal tunnel syndrome: A review

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