Determinants of the Maximal Nerve Cross-Sectional Area and Its Role in the Separation of Entrapment and Compression Ulnar Neuropathies at the Elbow.

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Muscle & Nerve Pub Date : 2026-09-01 Epub Date: 2026-06-21 DOI:10.1002/mus.70324

Simon Podnar

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引用次数: 0

Abstract

Introduction/aims: Nerve cross-sectional area (CSA) is the most robust and sensitive ultrasonographic indicator of nerve pathology. The study aimed to identify predictors of maximal CSA (CSA_max) in ulnar neuropathy at the elbow (UNE) and to assess its utility in elucidating the mechanism of UNE, which is potentially important for patient referral to a surgeon.

Methods: In a group of prospectively recruited UNE patients, 11 demographic, clinical, and electrodiagnostic features were recorded. CSA_max in the elbow segment was measured ultrasonographically. Explanatory variables for CSA_max were determined using a backward stepwise method of multiple linear regression analysis. To determine the CSA_max threshold with the best differentiation of retrocondylar compression and cubital tunnel entrapment (i.e., the UNE mechanism), a ROC curve was constructed.

Results: We studied 130 patients (94 men), aged 27-88 years (median 62 years). The only significant predictor of CSA_max was the mechanism of UNE (CSA_max = 7.49 + 6.89 UNE mechanism, SE 1.04, (adjusted) R ² = 0.25, p < 0.0001). The best differentiation between UNE mechanisms was obtained at the CSA_max of 16 mm² (sensitivity 0.80, positive predictive value 0.71).

Discussion: In UNE, the main determinant of CSA_max was the mechanism of neuropathy. In the UNE of unclear mechanism, CSA_max larger than 16 mm² is more in favor of a cubital tunnel entrapment. These findings suggest that US is more sensitive in the diagnosis of entrapment compared with compression neuropathies.

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最大神经横截面积的决定因素及其在肘部压迫和压迫性尺神经病变分离中的作用。

简介/目的：神经横断面积（Nerve cross-sectional area， CSA）是神经病理最可靠、最敏感的超声指标。该研究旨在确定肘部尺神经病变（UNE）最大CSA （CSAmax）的预测因素，并评估其在阐明UNE机制方面的效用，这对患者转诊外科医生可能很重要。方法：在一组前瞻性招募的UNE患者中，记录了11个人口学、临床和电诊断特征。超声测量肘关节段CSAmax。采用多元逐步回归分析方法确定CSAmax的解释变量。为了确定最能区分髁后压迫和肘管卡压的CSAmax阈值（即UNE机制），我们构建了ROC曲线。结果：我们研究了130例患者（94例男性），年龄27-88岁（中位62岁）。CSAmax唯一显著预测因子为UNE机制(CSAmax = 7.49 + 6.89, SE 1.04,（调整后）R2 = 0.25， p max为16 mm2（敏感性0.80，阳性预测值0.71）。讨论：在UNE中，CSAmax的主要决定因素是神经病变的机制。在机制不明的UNE中，CSAmax大于16 mm2更有利于肘管夹持。这些结果表明，与压迫性神经病相比，US在诊断卡压方面更为敏感。

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

Muscle & Nerve 医学-临床神经学

CiteScore

6.40

自引率

5.90%

发文量

287

审稿时长

3-6 weeks

期刊介绍： Muscle & Nerve is an international and interdisciplinary publication of original contributions, in both health and disease, concerning studies of the muscle, the neuromuscular junction, the peripheral motor, sensory and autonomic neurons, and the central nervous system where the behavior of the peripheral nervous system is clarified. Appearing monthly, Muscle & Nerve publishes clinical studies and clinically relevant research reports in the fields of anatomy, biochemistry, cell biology, electrophysiology and electrodiagnosis, epidemiology, genetics, immunology, pathology, pharmacology, physiology, toxicology, and virology. The Journal welcomes articles and reports on basic clinical electrophysiology and electrodiagnosis. We expedite some papers dealing with timely topics to keep up with the fast-moving pace of science, based on the referees'' recommendation.