Academic radiology · 2026
Multimodal Ultrasound Imaging for Pre- and Postoperative Evaluation of Carpal Tunnel Syndrome.
СтатьяНазвание и аннотация: Перевод в очереди
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Wu Chengrong, Wang Wenfei, Xie Xinya, Wang Yunyue, Mu Jingjing
Аннотация
OBJECTIVE: To evaluate the value of combining high-frequency ultrasound, sound touch elastography (STE), and ultramicro angiography (UMA) for the diagnosis and short-term postoperative follow-up of carpal tunnel syndrome (CTS) patients.
METHODS: This prospective study enrolled 50 CTS patients (78 wrists), classified by severity into mild (n = 22), moderate (n = 32), and severe (n = 24) groups, along with 35 healthy volunteers (70 wrists) as controls. All participants underwent multimodal ultrasound examination combining high-frequency ultrasound, STE, and UMA to measure median nerve cross-sectional area (CSA), shear wave velocity (SWV), and color pixel percentage (CPP) within 2 cm proximal to the carpal tunnel inlet. Patients with moderate and severe CTS underwent carpal tunnel release surgery followed by repeat ultrasound evaluation at 3 months postoperatively. Statistical comparisons included the following: (1) ultrasound parameters between preoperative CTS patients and controls; (2) parameter differences across severity subgroups; (3) pre-versus postoperative changes in CTS patients; and (4) diagnostic performance of individual and combined parameters for CTS identification.
RESULTS: Significant elevations in median nerve CSA, SWV, and CPP were observed at the carpal tunnel inlet in the CTS group compared to controls (all P < 0.001). Among CTS patients, CPP demonstrated progressive increases with severity across all subgroups (all P < 0.001). CSA was significantly larger in severe cases than in mild and moderate wrists (P < 0.001), while SWV values were higher in both moderate and severe cases compared to mild CTS (all P < 0.001). Receiver operating characteristic (ROC) analysis indicated that the combination of CSA, SWV, and CPP provided optimal diagnostic accuracy for CTS with area under the curve (AUC) of 0.990, with 96.2% sensitivity and 98.6% specificity. Postoperative assessment at 3 months revealed significant reductions in all three parameters compared to preoperative values (all P < 0.001).
CONCLUSION: Multimodal ultrasound provides clinical value in carpal tunnel syndrome by supporting early diagnosis and severity stratification, and it may serve as a useful tool for short-term postoperative monitoring.
METHODS: This prospective study enrolled 50 CTS patients (78 wrists), classified by severity into mild (n = 22), moderate (n = 32), and severe (n = 24) groups, along with 35 healthy volunteers (70 wrists) as controls. All participants underwent multimodal ultrasound examination combining high-frequency ultrasound, STE, and UMA to measure median nerve cross-sectional area (CSA), shear wave velocity (SWV), and color pixel percentage (CPP) within 2 cm proximal to the carpal tunnel inlet. Patients with moderate and severe CTS underwent carpal tunnel release surgery followed by repeat ultrasound evaluation at 3 months postoperatively. Statistical comparisons included the following: (1) ultrasound parameters between preoperative CTS patients and controls; (2) parameter differences across severity subgroups; (3) pre-versus postoperative changes in CTS patients; and (4) diagnostic performance of individual and combined parameters for CTS identification.
RESULTS: Significant elevations in median nerve CSA, SWV, and CPP were observed at the carpal tunnel inlet in the CTS group compared to controls (all P < 0.001). Among CTS patients, CPP demonstrated progressive increases with severity across all subgroups (all P < 0.001). CSA was significantly larger in severe cases than in mild and moderate wrists (P < 0.001), while SWV values were higher in both moderate and severe cases compared to mild CTS (all P < 0.001). Receiver operating characteristic (ROC) analysis indicated that the combination of CSA, SWV, and CPP provided optimal diagnostic accuracy for CTS with area under the curve (AUC) of 0.990, with 96.2% sensitivity and 98.6% specificity. Postoperative assessment at 3 months revealed significant reductions in all three parameters compared to preoperative values (all P < 0.001).
CONCLUSION: Multimodal ultrasound provides clinical value in carpal tunnel syndrome by supporting early diagnosis and severity stratification, and it may serve as a useful tool for short-term postoperative monitoring.