Ultrasound elastographic evaluation of the median nerve in hemodialysis with carpal tunnel syndrome

Hua, Xing; Hu, Hai-Yang; Liu, Bin; Liu, Xiang; Xia, Li; Li, Jie

doi:10.1007/s10396-016-0733-x

Cited by 18 publications

(12 citation statements)

References 27 publications

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“…The MN-CSA was not correlated with the dialysis vintage, a result that is in contrast to other previously published studies, which suggested the duration of dialysis treatment to be a significant risk factor for the development of CTS [5,13,35]. This difference can be explained by the relatively shorter duration of dialysis treatment in our cohort.…”

Section: Discussioncontrasting

confidence: 99%

“…Using clinical manifestations plus positive Tinel's test as the reference standard, MN-CSA with a threshold of 11.5 mm 2 can indicate the probability of CTS with 63% sensitivity and 80% specificity. This is consistent with a previous study carried out on 71 HD patients (22 with and 49 without CTS), which identified the cutoff value of the MN-CSA for detection of CTS as 11 mm 2 with 79.2% sensitivity and 84% specificity [13]. About one-third of this cohort had MN-CSA ≥ 11.5 mm 2 .…”

Section: Discussionsupporting

confidence: 92%

“…According to Borire et al [12], the MN-CSA correlated significantly with electrophysiological studies in HD patients. Moreover, Xin et al [13] found that the presence of CTS in HD patients can be predicted by a CSA cutoff value of 11 mm 2 with a sensitivity and specificity of 79.2% and 84%, respectively.…”

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confidence: 99%

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Clinical and ultrasonographic screening for carpal tunnel syndrome in hemodialysis patients

Tharwat

Nassar

2020

Kidney Res Clin Pract

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The prevalence of end-stage renal disease (ESRD) is increasing worldwide [1]. Maintenance hemodialysis (HD) therapy is the most common mode of renal replacement therapy [2]. HD patients are susceptible to many comorbid conditions, such as cardiovascular disease, anemia, and peripheral neuropathy [3].Peripheral neuropathy is a common complication that affects 60% to 100% of chronic kidney disease (CKD) patients [4]. Despite the adequacy of dialysis, peripheral neuropathy remains a major disabling problem that has a negative impact on the health-related quality of life of such patients [4]. This may be caused by uremic neuropa-

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 92%

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Clinical and ultrasonographic screening for carpal tunnel syndrome in hemodialysis patients

Tharwat

Nassar

2020

Kidney Res Clin Pract

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“…Several new sonographic techniques, such as dynamic US and US elastography, have been developed in recent years and have the potential to differentiate CTS of different severities. 10 – 12 However, the ultrasonic morphology of the carpal tunnel, including the anatomy of the median nerve, may vary according to ethnicity, sex, and age. 13 , 14 Cut-off values specific to different ethnic groups would be of great benefit for practicing clinicians and radiologists.…”

Section: Introductionmentioning

confidence: 99%

The value of sonographic quantitative parameters in the diagnosis of carpal tunnel syndrome in the Vietnamese population

Nguyen

et al. 2021

J Int Med Res

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Objective To examine the value of ultrasound (US) in the diagnosis of carpal tunnel syndrome (CTS) in the Vietnamese population. Methods This prospective cross-sectional study involved 42 wrists of 25 patients with idiopathic CTS evaluated by US. In addition, 38 wrists of 22 healthy volunteers were included as the control group. Results Significant differences in the median nerve cross-sectional area (CSA) at different levels were found between patients with CTS and controls. Using a cut-off value of 9.5 mm2 for the median nerve CSA at the pisiform (p-CSA), US had a sensitivity and specificity of 95.2% and 97.4%, respectively, for the diagnosis of CTS. Area under the curve analysis revealed a sensitivity and specificity of 100% and 95.4%, respectively, for the prediction of severe CTS using a p-CSA of >15.5 mm2. Conclusions The median nerve CSA is a highly accurate parameter in the diagnosis of CTS. We recommend using a p-CSA of >9.5 mm2 as a diagnostic criterion for CTS and a p-CSA of >15.5 mm2 as a marker for severe CTS in the Vietnamese population. Research Registry number: 7261

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“…Previous publications have described the potential of elastography for CTS, with the majority reporting increased nerve stiffness (ratios) in patients with CTS 20–32 ; three research studies reported no significant difference 33–35 . In addition, US elastography has been used to assess carpal ligament stiffness, 36,37 intra carpal tunnel pressure, 38,39 the correlation between median nerve area and strain 40 and the difference in median nerve elasticity before and after carpal tunnel release 41 .…”

Section: Introductionmentioning

confidence: 99%

Shear wave elastography of the median nerve: A mechanical study

et al. 2020

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Background: Shear wave elastography (SWE) shows promise in peripheral neuropathy evaluation but has potential limitations due to tissue size and heterogeneity. We tested SWE sensitivity to elasticity change and the effect of probe position in a median nerve cadaver model. Methods: Ten specimens were used to measure median nerve elasticity under increasing loads using SWE and indentation. Measurements were compared using repeated-measures analysis of variance. Results: Indentation and SWE-based longitudinal nerve elasticity increased with tensile loading (P < .01), showing a similar relationship. Acquisition in a transverse plane showed lower values compared with longitudinal measurements, mostly under higher loads (P = .03), as did postdissection elasticity (P = .02). Elasticity did not change when measured proximal to the carpal tunnel. Conclusions: Longitudinal SWE is sensitive to changes in median nerve elasticity. Measuring elasticity of peripheral nerves noninvasively could elucidate intra-neural pathology related to compression neuropathies, and proof to be of added value as a diagnostic or prognostic tool. K E Y W O R D S carpal tunnel syndrome, elastography, nerve elasticity, neurodynamics, peripheral neuropathy

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Ultrasound elastographic evaluation of the median nerve in hemodialysis with carpal tunnel syndrome

Abstract: Sonoelastography helps to improve the diagnostic accuracy of the ultrasonographic assessment of CTS.

Cited by 18 publications

References 27 publications

Clinical and ultrasonographic screening for carpal tunnel syndrome in hemodialysis patients

Clinical and ultrasonographic screening for carpal tunnel syndrome in hemodialysis patients

The value of sonographic quantitative parameters in the diagnosis of carpal tunnel syndrome in the Vietnamese population

Shear wave elastography of the median nerve: A mechanical study

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