Shear Wave Velocity of the Thenar Muscle Is Associated With the Neurophysiologic Severity of Carpal Tunnel Syndrome.

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neurophysiology Pub Date : 2025-03-19 DOI:10.1097/WNP.0000000000001157

Henri Grönfors, Katri Mäkelä, Sari-Leena Himanen

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引用次数: 0

Abstract

Purpose: Aim of the study was to examine the associations between abductor pollicis brevis (APB) muscle stiffness evaluated by shear wave elastography and electrodiagnostic study findings in patients with carpal tunnel syndrome. The association between shear wave elastography and APB muscle echogenicity was also examined.

Methods: This prospective study included patients who were referred to electrodiagnostic studies because of upper limb symptoms. The electrodiagnostic studies consisted of nerve conduction studies and needle-electromyography. Abductor pollicis brevis muscle shear wave velocity was measured, and muscle echogenicity assessed using the Heckmatt grading scale.

Results: In total, 97 hands were included in the nerve conduction studies. Of these, 53 APB muscles were further examined with needle-electromyography. Shear wave velocity correlated positively with the neurophysiologic severity of carpal tunnel syndrome (r = 0.449, P = 0.028, N = 26). Mean shear wave velocity was faster in the APB muscles with neurogenic findings (mean 2.72 m/second, ±SD 0.36) than muscles with normal findings (2.48 m/second, ±SD 0.34, P = 0.036). In receiver operating characteristic analysis, the best shear wave velocity cutoff value was 2.66 m/second. With this cutoff value, the sensitivity was 0.692, while the 1-specificity was 0.233. Only seven APB muscles showed increased echogenicity.

Conclusions: Shear wave velocity of APB muscle is positively associated with the neurophysiologic severity of carpal tunnel syndrome. Carpal tunnel syndrome-related axonal damage also seems to increase shear wave velocity in APB muscle; however, according to the receiver operating characteristic analysis, the method is not yet suitable for clinical use to define muscle denervation. The findings of this study show that shear wave elastography has potential as an additional clinical tool in the diagnostics of carpal tunnel syndrome.

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大鱼际肌肉的横波速度与腕管综合征的神经生理严重程度有关。

目的：本研究旨在探讨腕管综合征患者短拇外展肌僵硬度（APB）与剪切波弹性成像和电诊断结果之间的关系。横波弹性成像与APB肌肉回声性的关系也进行了研究。方法：这项前瞻性研究纳入了因上肢症状而进行电诊断研究的患者。电诊断研究包括神经传导研究和针肌电图。测量拇短外展肌横波速度，并使用Heckmatt分级量表评估肌肉回声性。结果：97只手被纳入神经传导研究。其中53块APB肌用针刺肌电图进一步检查。横波速度与腕管综合征神经生理严重程度呈正相关（r = 0.449, P = 0.028, N = 26）。有神经源性表现的APB肌肉的平均横波速度（平均2.72 m/s，±SD 0.36）快于正常表现的肌肉（2.48 m/s，±SD 0.34, P = 0.036）。在接收机工作特性分析中，最佳横波速度截止值为2.66 m/s。在此截止值下，敏感性为0.692，特异度为0.233。仅有7块APB肌回声增强。结论：APB肌横波速度与腕管综合征神经生理严重程度呈正相关。腕管综合征相关的轴突损伤似乎也增加了APB肌的剪切波速度；然而，根据受术者操作特征分析，该方法尚不适合临床用于确定肌肉去神经支配。本研究结果表明，剪切波弹性成像有潜力作为诊断腕管综合征的额外临床工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neurophysiology 医学-临床神经学

CiteScore

4.60

自引率

4.20%

发文量

198

审稿时长

6-12 weeks

期刊介绍： The Journal of Clinical Neurophysiology features both topical reviews and original research in both central and peripheral neurophysiology, as related to patient evaluation and treatment. Official Journal of the American Clinical Neurophysiology Society.