Research On The Values Of High-resolution Ultrasonography Applied In The Diagnosis Of Carpal Tunnel Syndrome

Objective: To verify the accuracy of high-resolution ultrasonography in measuringthe thickness of the transverse carpal ligament, and the anteroposterior diameter andtransverse diameter of the median nerve through comparing the results measured bypreoperative high-resolution ultrasonography (HRUS) with the results measured byvernier caliper directly during the surgery using statistical methods. Discuss thevalues of ultrasonography applied in the diagnosis and therapy for carpal tunnelsyndrome.Methods: Examine totally36affected arms from22patients who are diagnosed withcarpal tunnel syndrome by high-resolution ultrasonography before surgery. Measurethe thickness of the transverse carpal ligament as well as the anteroposterior diameterand transverse diameter of the median nerve with high-resolution ultrasonography onthe pisiform bone horizontal plane and the hamate bone hook horizontal planerespectively. Then calculate the flattening ratio of the median nerve on each horizontalplane. During the surgery, use vernier caliper to measure the thickness of thetransverse carpal ligament as well as the anteroposterior diameter and transversediameter of the median nerve on both the pisiform bone horizontal plane and thehamate bone hook horizontal plane. Then calculate the flattening ratio of the mediannerve on different horizontal planes. Compare the two groups of data which aremeasured by the above two means through statistical methods to verify the accuracyof high-resolution ultrasonography used in measuring the thickness of the transversecarpal ligament as well as the anteroposterior diameter and transverse diameter of themedian nerve. Results:1. Results measured by the high-resolution ultrasonography before surgery: Thethickness of the transverse carpal ligament on the pisiform horizontal plane is0.35189±0.06186cm. The flattening ratio of the median nerve on the pisiform horizontalplane is3.40057±0.33736. The thickness of the transverse carpal ligament on thehook of the hamate bone horizontal plane is0.42983±0.05674cm. The flatteningratio of the median nerve on the hamate bone hook horizontal plane is3.94953±0.34000.2. Results measured by vernier caliper directly during the surgery: The thickness ofthe transverse carpal ligament on the pisiform horizontal plane is0.35183±0.06179cm. The flattening ratio of the median nerve on the pisiform horizontal planeis3.38982±0.33912. The thickness of the transverse carpal ligament on the hamatebone hook horizontal plane is0.42940±0.05668cm. The flattening ratio of themedian nerve on the hamate bone hook horizontal plane is3.93331±0.33075.Use SPSS19.0to analyze the measuring results and carry out t tests to each group ofdata to get the P value.The data analysis results are as follows: Through carrying out t test to the data of thecarpal ligament thickness measured by the two means on the pisiform horizontal plane,we get P1=0.807(P1>0.05). Through carrying out t test to the data of the carpalligament thickness measured by the two means on the hamate bone hook horizontalplane, we get P2=0.202(P2>0.05). Through carrying out t test to the data of themedian nerve flattening ratio measured by the two means on the pisiform horizontalplane, we get P3=0.120(P3>0.05). Through carrying out t test to the data of themedian nerve flattening ratio measured by the two means on the hamate bone hookhorizontal plane, we get P4=0.305(P4>0.05). Conclusion: There is no significant difference between the results measured byhigh-resolution ultrasonography before surgery and the results measured by verniercaliper directly during the surgery. It proves that high-resolution ultrasonography is ofhigh accuracy used in measuring the thickness of the transverse carpal ligament andthe anteroposterior diameter and transverse diameter of the median nerve.High-resolution ultrasonography can be applied to examine the median nerve and thetissue surrounding the carpal tunnel simply, conveniently, quickly, accurately andnon-invasively. It illustrates that the high-resolution ultrasonography plays animportant role in the diagnosis and therapy for carpal tunnel syndrome.