Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2012
Which ultrasonographic measure has the upper hand in ulnar neuropathy at the elbow?
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Pompe Sander M, Beekman Roy
Аннотация
OBJECTIVE: To compare the diagnostic accuracy of ultrasonographic ulnar nerve diameter, cross-sectional area (CSA) and swelling ratio measurement in ulnar neuropathy at the elbow (UNE).
METHODS: Ultrasonographic diameter, CSA, and swelling ratio measurements were compared with a reference standard including clinical examination, electrophysiological studies, and follow-up in a prospective cohort of patients. All patients in whom a diagnosis of UNE was considered were eligible for the study. Reference values for ultrasonography were obtained in 73 healthy volunteers.
RESULTS: Of 191 patients, 137 had UNE or probable UNE, while 54 had another condition and these were analysed as patient controls. Patients with UNE had a larger ulnar nerve diameter, CSA and swelling ratio than healthy controls and patient controls (p < 0.01). The diagnostic accuracies of these different measurements were comparable with a specificity of 78-87%, a positive predictive value of 87-90%, a sensitivity of 42-61% and negative predictive value of 37-44%. ROC-analysis for these measurements showed an area under the curve of 0.75-0.77.
CONCLUSION: Ultrasonographic measurements of ulnar nerve diameter, CSA and swelling ratio have comparable diagnostic value, which was lower than reported previously.
SIGNIFICANCE: Ultrasonographic ulnar nerve diameter, CSA and swelling ratio measurements are equally useful in diagnosing UNE.
METHODS: Ultrasonographic diameter, CSA, and swelling ratio measurements were compared with a reference standard including clinical examination, electrophysiological studies, and follow-up in a prospective cohort of patients. All patients in whom a diagnosis of UNE was considered were eligible for the study. Reference values for ultrasonography were obtained in 73 healthy volunteers.
RESULTS: Of 191 patients, 137 had UNE or probable UNE, while 54 had another condition and these were analysed as patient controls. Patients with UNE had a larger ulnar nerve diameter, CSA and swelling ratio than healthy controls and patient controls (p < 0.01). The diagnostic accuracies of these different measurements were comparable with a specificity of 78-87%, a positive predictive value of 87-90%, a sensitivity of 42-61% and negative predictive value of 37-44%. ROC-analysis for these measurements showed an area under the curve of 0.75-0.77.
CONCLUSION: Ultrasonographic measurements of ulnar nerve diameter, CSA and swelling ratio have comparable diagnostic value, which was lower than reported previously.
SIGNIFICANCE: Ultrasonographic ulnar nerve diameter, CSA and swelling ratio measurements are equally useful in diagnosing UNE.