Combination of high-frequency ultrasound and virtual touch tissue imaging and quantification improve the diagnostic efficiency for mild carpal tunnel syndrome

Zhen-Han Lai,Kun-Bin Wu,Li-Ping Liao,Shu-Ping Yang,Xiao-Han Cai,Hao-Lin Shen,Wen-Ting Jiang,Guo-Rong Lv,Yi Luo

doi:10.1186/s12891-021-03982-7

Abstract

BackgroundCarpal tunnel syndrome (CTS) is the most common entrapment symptom in the peripheral nerves. High-frequency ultrasound (HFUS) is widely used in the diagnosis of CTS. Virtual Touch Tissue Imaging and Quantification (VTIQ), which provides more information about the hardness of organization, is used to diagnose CTS. However, the data of diagnostic value of them in various degrees of CTS are limited. Whether the combination of HFUS and VTIQ can improve the diagnostic efficiency also remains unknown. The study aimed to explore the diagnostic value of HFUS and VTIQ in various degrees of CTS and whether combination of HFUS and VTIQ could improve the diagnostic efficiency of CTS.MethodsA collection and analysis of 133 CTS patients and 35 volunteers from January 2016 to January 2019 were performed. We compared the clinical characteristics, cross-sectional area (CSA) value and shear wave velocity SWVmean value of CTS group with volunteer group.ResultsThe CSA value and SWVmean value of CTS cohort were significantly higher than volunteer group (10.79 ± 2.88 vs. 8.06 ± 1.39, p < 0.001, 4.36 ± 0.95 vs. 3.38 ± 1.09, p < 0.001, respectively). The area under the curve (AUC) of receiver operating characteristic (ROC) curve of CSA value and SWVmean value were 0.794 and 0.757, respectively. Hierarchical analysis of CSA value and SWVmean value showed that the AUC in the moderate and severe CTS group were higher than in mild CTS group. Furthermore, the CSA value combined with SWVmean value used to diagnose mild CTS was 0.758, which was higher than that of single CSA value or single SWVmean value.ConclusionsBoth HFUS and VTIQ technology were feasible to evaluate CTS. HFUS was suitable for use in diagnosis of moderate and severe CTS. For mild CTS, combination of HFUS and VTIQ was relevant to improve the diagnostic efficiency of CTS.

Highlights

Carpal tunnel syndrome (CTS) is the most common entrapment symptom in the peripheral nerves
The cross-sectional area (CSA) value of the CTS cohort was significantly higher than volunteers (10.79 ± 2.88 vs. 8.06 ± 1.39, p < 0.001), while the SWVmean value significantly higher than volunteers (4.36 ± 0.95 vs. 3.38 ± 1.09, p < 0.001)
The results showed that the area under the curve (AUC) in moderate and severe CTS group were respectively

Summary

Introduction

Carpal tunnel syndrome (CTS) is the most common entrapment symptom in the peripheral nerves. High-frequency ultrasound (HFUS) is widely used in the diagnosis of CTS. Carpal tunnel syndrome (CTS) is a common entrapment neuropathy of the median nerve characterized by paresthesias and pain in the first to fourth digits. The diagnosis of carpal tunnel syndrome is mostly based on a combination of clinical symptoms, signs, and an imaging examination. Kapuścińska et al [9] found that ultrasound imaging with the use of high-frequency ultrasound (HFUS) was a valuable diagnostic tool for assessing the surgical treatment in CTS patients. More and more research reported that newer ultrasound techniques, such as power Doppler, microvascular imaging, and elastography, might improve the specificity and sensitivity of ultrasound examination in the evaluation of CTS [2, 10, 11]

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