Electroneurophysiological And Ultrasonographic Examination Sensitivity Analysis Of Carpal Tunnel Syndrome

[Aims]The study was to investigate the neurophysiological and ultrasonographic imaging characteristics of36CTS patients who meet with the diagnostic and clinical neurophysiological criteria. In this research, high-resolution ultrasonography was adopted to examine their wrists. The objective of this research is to analyze the sensitivity of neurophysiological and ultrasono graphic detection and provide basis for clinical decisions on non-operation therapy or operation therapy.[Subjects And Methods]We collected the data of36CTS patients (61hands) who received hospital examination in our hospital from October2011to February2012with the following standard as the case group. Inclusion criteria included both clinical diagnostic criteria and electrophysiological diagnostic criteria for case group. Combining with existing literature, we summarize and analyze the patients’ clinical manifestation, their electroneurophysiological characteristics, and their ultrasonographic imaging characteristics and respective sensitivity. The relevant research progress is also presented.[Results]Clinical feature:Among36CTS patients (28-64years old),12patients are male,24patients are female, and their mean age is48.86years; There are5cases which are on the left side,6are on the right and25are bilateral, the duration of CTS disease is0.5months to16years, and the mean duration is30.17months. Electrophysiological test results:in this study,36cases with CTS met the clinical diagnosis standard and electrophysiological diagnostic criteria. Electrophysiological examination result: positive rate was96.72%, median nerve sensory conduction abnormal rate was95.08%, in which DSL abnormal rate91.80%, SCV abnormal rate was88.52%, SNAP abnormal rate was27.87%, and the rate which sensory potentials couldn’t be evoked was3.28%; motor conduction abnormal rate was86.89%, in which DML abnormal rate was81.97%, the rate of CAMP decreased more than50%was9.84%, lower40%～50%was4.92%; Electromyogram detection indicate that abnormal rate of abductor pollicis brevis muscle neurogenically damaged was34.43%. High-resolution ultrasonographic detection indicated that the positive rate was90.16%. Among them, d1decreases in39.34%sides, d2increases in81.97%sides, d3decreases in67.21%sides, and d4increases in83.61%sides. Ultrasonographic examination showed that except for the increased pressure of median nerve in carpal tunnel, the tendon inflammation had effusive changes and nerve atrophy.[Conclusion]Electroneurophysiological examination of CTS has high sensitivity, and the accuracy of ultrasonographic examination is also quite high. Electroneurophysiology reflects the median nerve functional status, and so we can exclude cervical spinal nerve discase, detect muscle disease is neurogenic or myogenic, and determine the degree of nerve damage. The advantage of high-resolution ultrasonographic imaging lies in that it judges the histological changes from the anatomical angle, and thus it can provide valuable information for clinical operations. Electroneurophysiological and ultrasonographic examinations provide valuable information for clinical research, on an equal level while the impaction of electroneurophysiology is superior to that of ultrasonographic imaging. Electroneurophysiological examination combined with ultrasonographic examination improves the diagnostic accuracy.