Diagnostic Cutoff Value for Ultrasonography in the Ulnar Neuropathy at the Elbow
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Objective To determine the diagnostic cutoff values of ultrasonographic measurements in ulnar neuropathy at the elbow (UNE).Methods Twenty-five elbows of 23 patients (9 females, 16 males) diagnosed with UNE and 30 elbows of 30 healthy controls (15 females, 15 males) were included in our study. The ulnar nerve cross-sectional area (CSA) was measured at the Guyon canal, midforearm, and maximal swelling point (MS) around the elbow (the cubital tunnel inlet in healthy controls). CSA measurements of the ulnar nerve at each point, the Guyon canal-to-MS ulnar nerve area ratio (MS/G), and the midforearm-to-MS ulnar nerve ratio (MS/F) were calculated.Results Among the variables, only CSA at MS, MS/G, and MS/F displayed significant differences between the control and patient groups. The cutoff value for diagnosing UNE was 8.95 mm2 for the CSA at MS (sensitivity 93.8%, specificity 88.3%), 1.99 for the MS/G (sensitivity 75.0%, specificity 73.3%), and 1.48 for the MS/F (sensitivity 93.8%, specificity 95.0%).Conclusion These findings may be helpful to diagnose UNE.
Abstract
Objective To determine the diagnostic cutoff values of ultrasonographic measurements in ulnar neuropathy at the elbow (UNE).Methods Twenty-five elbows of 23 patients (9 females, 16 males) diagnosed with UNE and 30 elbows of 30 healthy controls (15 females, 15 males) were included in our study. The ulnar nerve cross-sectional area (CSA) was measured at the Guyon canal, midforearm, and maximal swelling point (MS) around the elbow (the cubital tunnel inlet in healthy controls). CSA measurements of the ulnar nerve at each point, the Guyon canal-to-MS ulnar nerve area ratio (MS/G), and the midforearm-to-MS ulnar nerve ratio (MS/F) were calculated.Results Among the variables, only CSA at MS, MS/G, and MS/F displayed significant differences between the control and patient groups. The cutoff value for diagnosing UNE was 8.95 mm2 for the CSA at MS (sensitivity 93.8%, specificity 88.3%), 1.99 for the MS/G (sensitivity 75.0%, specificity 73.3%), and 1.48 for the MS/F (sensitivity 93.8%, specificity 95.0%).Conclusion These findings may be helpful to diagnose UNE.
참고문헌 (24)
- Chiou HJ, "Cubital tunnel syndrome: diagnosis by high-resolution ultrasonography", J Ultrasound Med, 17, pp.643~648 (1998)
- Kitzinger HB, "Significance of electroneurographic parameters in the diagnosis of chronic neuropathy of the ulnar nerve at the elbow", Handchir Mikrochir Plast Chir, 37, pp.276~281 (2005)
- Wiesler ER, "Ultrasound in the diagnosis of ulnar neuropathy at the cubital tunnel", J Hand Surg Am, 31, pp.1088~1093 (2006)
- Beekman R, "Diagnostic value of high-resolution sonography in ulnar neuropathy at the elbow", Neurology, 62, pp.767~773 (2004)
- Nakamichi K, "Ultrasonographic measurement of median nerve cross-sectional area in idiopathic carpal tunnel syndrome: diagnostic accuracy", Muscle Nerve, 26, pp.798~803 (2002)
- Yoon JS, "Ultrasonographic measurements in cubital tunnel syndrome", Muscle Nerve, 36, pp.853~855 (2007)
- Bayrak AO, "Ultrasonography in patients with ulnar neuropathy at the elbow: comparison of cross-sectional area and swelling ratio with electrophysiological severity", Muscle Nerve, 41, pp.661~666 (2010)
- Yoon JS, "Ultrasonographic swelling ratio in the diagnosis of ulnar neuropathy at the elbow", Muscle Nerve, 38, pp.1231~1235 (2008)
- Mondelli M, "Ultrasonography in ulnar neuropathy at the elbow: relationships to clinical and electrophysiological findings", Neurophysiol Clin, 38, pp.217~226 (2008)
- Gruber H, "The validity of ultrasonographic assessment in cubital tunnel syndrome: the value of a cubital-to-humeral nerve area ratio (CHR)combined with morphologic features", Ultrasound Med Biol, 36, pp.376~382 (2010)
- Ozturk E, "Sonographic appearances of the normal ulnar nerve in the cubital tunnel", J Clin Ultrasound, 36, pp.325~329 (2008)
- Hobson-Webb LD, "The ultrasonographic wrist-to-forearm median nerve area ratio in carpal tunnel syndrome", Clin Neurophysiol, 119, pp.1353~1357 (2008)
- Jacob D, "Sonoanatomy of the ulnar nerve in the cubital tunnel: a multicentre study by the GEL", Eur Radiol, 14, pp.1770~1773 (2004)
- Volpe A, "Ultrasound evaluation of ulnar neuropathy at the elbow: correlation with electrophysiological studies", Rheumatology (Oxford), 48, pp.1098~1101 (2009)
- American Association of Electrodiagnostic Medicine, "Practice parameter for electrodiagnostic studies in ulnar neuropathy at the elbow: summary statement", Muscle Nerve, 22, pp.408~411 (1999)
- Contreras MG, "Anatomy of the ulnar nerve at the elbow: potential relationship of acute ulnar neuropathy to gender differences", Clin Anat, 11, pp.372~378 (1998)
- Kara M, "Musculoskeletal ultrasound for peripheral nerve lesions", Eur J Phys Rehabil Med, 48, pp.665~674 (2012)
- Polatsch DB, "Ulnar nerve anatomy", Hand Clin, 23, pp.283~289 (2007)
- Yalcin E, "Ultrasound diagnosis of ulnar neuropathy: comparison of symptomatic and asymptomatic nerve thickness", J Hand Surg Eur Vol, 39, pp.167~171 (2014)
- Won SJ, "Reference values for nerve ultrasonography in the upper extremity", Muscle Nerve, 47, pp.864~871 (2013)
- Cartwright MS, "Cross-sectional area reference values for nerve ultrasonograph", Muscle Nerve, 37, pp.566~571 (2008)
- Cartwright MS, "Ultrasonographic findings of the normal ulnar nerve in adults", Arch Phys Med Rehabil, 88, pp.394~396 (2007)
- Landau ME, "Effect of body mass index on ulnar nerve conduction velocity, ulnar neuropathy at the elbow, and carpal tunnel syndrome", Muscle Nerve, 32, pp.360~363 (2005)
- Park GY, "The ultrasonographic and electrodiagnostic findings of ulnar neuropathy at the elbow", Arch Phys Med Rehabil, 85, pp.1000~1005 (2004)
