Shawn C Roll, Sandy C Takata, Buwen Yao, Lynn Kysh, Wendy J Mack
{"title":"正中神经横截面积的声像图参考值：健康人数据的荟萃分析。","authors":"Shawn C Roll, Sandy C Takata, Buwen Yao, Lynn Kysh, Wendy J Mack","doi":"10.1177/87564793231176009","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Establish median nerve CSA reference values and identify patient-level factors impacting diagnostic thresholds.</p><p><strong>Methods: </strong>Studies were identified through a robust search of multiple databases, and quality assessment was conducted using a modified version of the National Institute of Health Study Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. A meta-analysis was performed to identify normative values stratified by anatomic location. A meta-regression was conducted to examine heterogeneity effects of age, sex, and laterality.</p><p><strong>Results: </strong>The meta-analysis included 73 studies; 41 (56.2%) were high quality. The median nerve CSA [95% CI] was 6.46mm<sup>2</sup> [6.09-6.84], 8.68mm<sup>2</sup> [8.22-9.13], and 8.60mm<sup>2</sup> [8.23-8.97] at the proximal forearm, the carpal tunnel inlet, and the proximal carpal tunnel, respectively. Age was positively associated with CSA at the level of proximal carpal tunnel (β=0.03mm<sup>2</sup>, p=0.047). Men (9.42mm<sup>2</sup>, [8.06-10.78]) had statistically larger proximal tunnel CSA (p = 0.03) as compared to women (7.71mm<sup>2</sup>, [7.01-8.42]). No difference was noted in laterality.</p><p><strong>Conclusion: </strong>A reference value for median nerve CSA in the carpal tunnel is 8.60mm<sup>2</sup>. Adjustments may be required in pediatrics or older adults. The diagnostic threshold of 10.0mm<sup>2</sup> for male patients should be cautiously applied as the upper limit of normative averages surpasses this threshold.</p>","PeriodicalId":45758,"journal":{"name":"JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY","volume":null,"pages":null},"PeriodicalIF":0.3000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468154/pdf/","citationCount":"0","resultStr":"{\"title\":\"Sonographic reference values for median nerve cross-sectional area: A meta-analysis of data from healthy individuals.\",\"authors\":\"Shawn C Roll, Sandy C Takata, Buwen Yao, Lynn Kysh, Wendy J Mack\",\"doi\":\"10.1177/87564793231176009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Establish median nerve CSA reference values and identify patient-level factors impacting diagnostic thresholds.</p><p><strong>Methods: </strong>Studies were identified through a robust search of multiple databases, and quality assessment was conducted using a modified version of the National Institute of Health Study Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. A meta-analysis was performed to identify normative values stratified by anatomic location. A meta-regression was conducted to examine heterogeneity effects of age, sex, and laterality.</p><p><strong>Results: </strong>The meta-analysis included 73 studies; 41 (56.2%) were high quality. The median nerve CSA [95% CI] was 6.46mm<sup>2</sup> [6.09-6.84], 8.68mm<sup>2</sup> [8.22-9.13], and 8.60mm<sup>2</sup> [8.23-8.97] at the proximal forearm, the carpal tunnel inlet, and the proximal carpal tunnel, respectively. Age was positively associated with CSA at the level of proximal carpal tunnel (β=0.03mm<sup>2</sup>, p=0.047). Men (9.42mm<sup>2</sup>, [8.06-10.78]) had statistically larger proximal tunnel CSA (p = 0.03) as compared to women (7.71mm<sup>2</sup>, [7.01-8.42]). No difference was noted in laterality.</p><p><strong>Conclusion: </strong>A reference value for median nerve CSA in the carpal tunnel is 8.60mm<sup>2</sup>. Adjustments may be required in pediatrics or older adults. The diagnostic threshold of 10.0mm<sup>2</sup> for male patients should be cautiously applied as the upper limit of normative averages surpasses this threshold.</p>\",\"PeriodicalId\":45758,\"journal\":{\"name\":\"JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.3000,\"publicationDate\":\"2023-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468154/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/87564793231176009\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/6/6 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/87564793231176009","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/6/6 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Sonographic reference values for median nerve cross-sectional area: A meta-analysis of data from healthy individuals.
Objective: Establish median nerve CSA reference values and identify patient-level factors impacting diagnostic thresholds.
Methods: Studies were identified through a robust search of multiple databases, and quality assessment was conducted using a modified version of the National Institute of Health Study Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. A meta-analysis was performed to identify normative values stratified by anatomic location. A meta-regression was conducted to examine heterogeneity effects of age, sex, and laterality.
Results: The meta-analysis included 73 studies; 41 (56.2%) were high quality. The median nerve CSA [95% CI] was 6.46mm2 [6.09-6.84], 8.68mm2 [8.22-9.13], and 8.60mm2 [8.23-8.97] at the proximal forearm, the carpal tunnel inlet, and the proximal carpal tunnel, respectively. Age was positively associated with CSA at the level of proximal carpal tunnel (β=0.03mm2, p=0.047). Men (9.42mm2, [8.06-10.78]) had statistically larger proximal tunnel CSA (p = 0.03) as compared to women (7.71mm2, [7.01-8.42]). No difference was noted in laterality.
Conclusion: A reference value for median nerve CSA in the carpal tunnel is 8.60mm2. Adjustments may be required in pediatrics or older adults. The diagnostic threshold of 10.0mm2 for male patients should be cautiously applied as the upper limit of normative averages surpasses this threshold.
期刊介绍：
The Journal of Diagnostic Medical Sonography (JDMS) is the official journal of the Society of Diagnostic Medical Sonography and publishes peer-reviewed manuscripts aimed at the translational use of ultrasound for diagnosis, intervention, and other clinical applications. The JDMS provides research, clinical, and educational content for all specialties including but not limited to abdominal, women’s health, pediatric, cardiovascular, and musculoskeletal sonography. The journal’s scope may also include research on instrumentation, physics, ergonomics, technical advancements, education, and professional issues in the field of sonography. Types of submissions accepted by the JDMS are Original Research, Literature Review, Case Studies, Symposia (related to education, policy, technology, or professional issues), and Letters to the Editor.
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