Median nerve stiffness measurement by shear wave elastography: a potential sonographic method in the diagnosis of carpal tunnel syndrome

Kantarcı, Fatih; Ustabaşıoğlu, Fethi Emre; Delil, Şakir; Olgun, Deniz Çebi; Korkmazer, Bora; Dikici, Atilla Süleyman; Tutar, Onur; Nalbantoğlu, Mecbure; Uzun, Nurten; Mihmanlı, İsmail

doi:10.1007/s00330-013-3023-7

Cited by 164 publications

(201 citation statements)

References 33 publications

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“…On the other hand there was not a statistically significant difference between Group 1 and Group 2 (p=0.245), similarly between Group 2 and Group 3 (p=1). with carpal tunnel syndrome compared to healthy volunteers in accordance with the results of our study [25]. Furthermore the authors were also able to obtain higher median nerve stiffness values in patients with severe or extremely severe CTS compared to patients with mildly or moderately severe CTS unlike our results.…”

Section: Rte Measurements Sr Measurements At the Level Of Carpal Tunnsupporting

confidence: 91%

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

et al. 2016

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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.

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Section: Rte Measurements Sr Measurements At the Level Of Carpal Tunnsupporting

confidence: 91%

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

et al. 2016

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“…There are few studies evaluating the peripheral nerves (30)(31)(32). In our experience, nerves in patients with neuropathies show higher shear-wave velocities than normal nerves.…”

Section: Swe Of Nervesmentioning

confidence: 98%

“…Promising results have been published in the recent literature on the utility of SWE in the evaluation of several traumatic and pathologic conditions of various musculoskeletal soft tissues, including tendons (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17), muscles (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29), nerves (30)(31)(32), and ligaments (33)(34)(35).…”

Section: Introductionmentioning

confidence: 99%

Shear-Wave Elastography: Basic Physics and Musculoskeletal Applications

et al. 2017

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In the past 2 decades, sonoelastography has been progressively used as a tool to help evaluate soft-tissue elasticity and add to information obtained with conventional gray-scale and Doppler ultrasonographic techniques. Recently introduced on clinical scanners, shearwave elastography (SWE) is considered to be more objective, quantitative, and reproducible than compression sonoelastography with increasing applications to the musculoskeletal system. SWE uses an acoustic radiation force pulse sequence to generate shear waves, which propagate perpendicular to the ultrasound beam, causing transient displacements. The distribution of shear-wave velocities at each pixel is directly related to the shear modulus, an absolute measure of the tissue's elastic properties. Shear-wave images are automatically coregistered with standard B-mode images to provide quantitative color elastograms with anatomic specificity. Shear waves propagate faster through stiffer contracted tissue, as well as along the long axis of tendon and muscle. SWE has a promising role in determining the severity of disease and treatment followup of various musculoskeletal tissues including tendons, muscles, nerves, and ligaments. This article describes the basic ultrasound physics of SWE and its applications in the evaluation of various traumatic and pathologic conditions of the musculoskeletal system.

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“…Previously, CSA of the median nerve and stiffness of the median nerve was studied in carpal tunnel syndrome [8][9][10]. The deformity of the median nerve during wrist flexion or extension has already been shown and the CSA of the median nerve has been reported to decrease during wrist motion [5].…”

Section: Discussionmentioning

confidence: 99%

Effects of chronic flexed wrist posture on the elasticity and crosssectional area of the median nerve at the carpal tunnel among chronic stroke patients

Aslan

Analan

2018

Med Ultrason

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Aim: To investigate the effects of chronic flexed wrist posture following spasticity on the elasticity and cross-sectional area (CSA) of the median nerve at the carpal tunnel among chronic stroke patients.Material and method: This prospective study included 24 consecutive patients (mean age, 56.5±11.56 years) with unilateral wrist spasticity following a stroke in a chronic phase. The CSA of the median nerve was measured by ultrasound (US). The elasticity was measured by Virtual Touch tissue imaging quantification (VTIQ; Siemens, Erlangen, Germany). SWV and CSA of the median nerves of the affected and unaffected sides for each patient were compared. The correlations between duration of time since the stroke, SWV and CSA of the median nerve were assessed. The interobserver agreement was assessed.Results: The CSA of the median nerve at the affected side was significantly lower than that of the unaffected side (p = 0.03). The SWV of the median nerve at the affected side was significantly higher than that on the unaffected side (p < 0.001). The interobserver agreement was excellent for both CSA and SWV measurements. There was a negatively fair correlation between CSA at the affected side and duration of time since stroke (r = -0.58, p < 0.05). The SWV of the median nerve at the affected side was not correlated with the duration of time since stroke (r ≤ 0.3, p ≥ 0.05).Conclusions: These results suggest that chronic flexed wrist posture may cause atrophy of the median nerve due to chronic compression after stroke and increase in the stiffness of the median nerve.

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Median nerve stiffness measurement by shear wave elastography: a potential sonographic method in the diagnosis of carpal tunnel syndrome

Cited by 164 publications

References 33 publications

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

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

Shear-Wave Elastography: Basic Physics and Musculoskeletal Applications

Effects of chronic flexed wrist posture on the elasticity and crosssectional area of the median nerve at the carpal tunnel among chronic stroke patients

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