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Shear wave elastography is a valuable tool for diagnosing and grading carpal tunnel syndrome

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Abstract

Objective

To quantify the shear velocity and stiffness of the median nerve (MN) with shear wave elastography (SWE) at the carpal tunnel entrance and determine whether SWE is useful for diagnosing and staging carpal tunnel syndrome (CTS).

Materials and methods

The study included 58 patients (79 wrists) with clinical and electroneuromyographic diagnoses of CTS and 55 healthy controls (63 wrists). MN shear velocity and stiffness were measured by SWE on the axial plane in both groups. The differences between CTS patients and controls and between different grades of CTS based on electrodiagnostic tests were studied using Student’s t test and ANOVA with ROC analysis.

Results

The mean MN shear velocity and stiffness were significantly greater in CTS patients (2.5 ± 0.37 m/s and 19.4 ± 5.8 kPa) than in controls (1.91 ± 0.24 m/s and 11.1 ± 3.0 kPa) (p < 0.001) and greater in the severe CTS group (2.69 ± 0.39 m/s and 22.4 ± 7.1 kPa) than in the mild CTS group (2.37 ± 0.35 m/s and 17.3 ± 4,8 kPa). The cutoff value for the shear velocity was 2.13 m/s, with 86% and 82% sensitivity and specificity, respectively, and the cutoff value for stiffness was 13.6 kPa, with 87% and 82% sensitivity and specificity.

Conclusion

MN shear velocity and stiffness are significantly higher in CTS patients. SWE can be used to diagnose CTS and distinguish between patients with mild and severe disease.

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References

  1. Xin H, Hu HY, Liu B, Liu X, Li X, Li J. Ultrasound elastographic evaluation of the median nerve in hemodialysis with carpal tunnel syndrome. J Med Ultrason (2001). 2017;44(1):123–31.

    Article  Google Scholar 

  2. Kantarci F, Ustabasioglu FE, Delil S, Olgun DC, Korkmazer B, Dikici AS, et al. Median nerve stiffness measurement by shear wave elastography: a potential sonographic method in the diagnosis of carpal tunnel syndrome. Eur Radiol. 2014;24(2):434–40.

    Article  Google Scholar 

  3. Koyuncuoglu HR, Kutluhan S, Yesildag A, Oyar O, Guler K, Ozden A. The value of ultrasonographic measurement in carpal tunnel syndrome in patients with negative electrodiagnostic tests. Eur J Radiol. 2005;56(3):365–9.

    Article  Google Scholar 

  4. Yu G, Chen Q, Wang D, Wang X, Li Z, Zhao J, et al. Diagnosis of carpal tunnel syndrome assessed using high-frequency ultrasonography: cross-section areas of 8-site median nerve. Clin Rheumatol. 2016;35(10):2557–64.

    Article  Google Scholar 

  5. El Habashy HR, El Hadidy RA, Ahmed SM, El Sayed BB, Ahmed AS. Carpal tunnel syndrome grading using high-resolution ultrasonography. J Clin Neurophysiol. 2017;34(4):353–8.

    Article  Google Scholar 

  6. Moschovos C, Tsivgoulis G, Kyrozis A, Ghika A, Karachalia P, Voumvourakis K, et al. The diagnostic accuracy of high-resolution ultrasound in screening for carpal tunnel syndrome and grading its severity is moderated by age. Clin Neurophysiol. 2019;130(3):321–30.

    Article  Google Scholar 

  7. Schrier VJMM, Lin J, Gregory A, Thoreson AR, Alizad A, Amadio PC, et al. Shear wave elastography of the median nerve: a mechanical study. Muscle Nerve. 2020;61(6):826–33.

    Article  Google Scholar 

  8. Zakrzewski J, Zakrzewska K, Pluta K, Nowak O, Miłoszewska-Paluch A. Ultrasound elastography in the evaluation of peripheral neuropathies: a systematic review of the literature. Pol J Radiol. 2019;84:e581-591.

    Article  Google Scholar 

  9. Taljanovic MS, Gimber LH, Becker GW, Latt LD, Klauser AS, Melville DM, et al. Shear-wave elastography: basic physics and musculoskeletal applications. Radiographics. 2017;37(3):855–70.

    Article  Google Scholar 

  10. Moran L, Royuela A, De Vargas AP, Lopez A, Cepeda Y, Martinelli G. Carpal tunnel syndrome: diagnostic usefulness of ultrasound measurement of the median nerve area and quantitative elastographic measurement of the median nerve stiffness. J Ultrasound Med. 2020;39(2):331–9.

    Article  Google Scholar 

  11. Lin CP, Chen IJ, Chang KV, Wu WT, Özçakar L. Utility of ultrasound elastography in evaluation of carpal tunnel syndrome: a systematic review and meta-analysis. Ultrasound Med Biol. 2019;45(11):2855–65.

    Article  Google Scholar 

  12. Miyamoto H, Morizaki Y, Kashiyama T, Tanaka S. Grey-scale sonography and sonoelastography for diagnosing carpal tunnel syndrome. World J Radiol. 2016;8(3):281–7.

    Article  Google Scholar 

  13. Nam K, Peterson SM, Wessner CE, Machado P, Forsberg F. Diagnosis of carpal tunnel syndrome using shear wave elastography and high-frequency ultrasound imaging. Acad Radiol. 2021;28(9):e278-287.

    Article  Google Scholar 

  14. Wee TC, Simon NG. Ultrasound elastography for the evaluation of peripheral nerves: a systematic review. Muscle Nerve. 2019;60(5):501–12.

    Article  Google Scholar 

  15. Cingoz M, Kandemirli SG, Alis DC, Samanci C, Kandemirli GC, Adatepe NU. Evaluation of median nerve by shear wave elastography and diffusion tensor imaging in carpal tunnel syndrome. Eur J Radiol. 2018;101:59–64.

    Article  Google Scholar 

  16. American Association of Electrodiagnostic Medicine AeAoN, and American Academy of Physical Medicine and Rehabilitation. Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: summary statement. Muscle Nerve. 2002; 25(6):918–922.

  17. Padua L, LoMonaco M, Gregori B, Valente EM, Padua R, Tonali P. Neurophysiological classification and sensitivity in 500 carpal tunnel syndrome hands. Acta Neurol Scand. 1997;96(4):211–7.

    Article  CAS  Google Scholar 

  18. Wee TC, Simon NG. Shearwave elastography in the differentiation of carpal tunnel syndrome severity. PM R. 2020;12(11):1134–9.

    Article  Google Scholar 

  19. Paluch Ł, Pietruski P, Walecki J, Noszczyk BH. Wrist to forearm ratio as a median nerve shear wave elastography test in carpal tunnel syndrome diagnosis. J Plast Reconstr Aesthet Surg. 2018;71(8):1146–52.

    Article  Google Scholar 

  20. Zhang C, Li M, Jiang J, Zhou Q, Xiang L, Huang Y, et al. Diagnostic value of virtual touch tissue imaging quantification for evaluating median nerve stiffness in carpal tunnel syndrome. J Ultrasound Med. 2017;36(9):1783–91.

    Article  Google Scholar 

  21. He Y, Xiang X, Zhu BH, Qiu L. Shear wave elastography evaluation of the median and tibial nerve in diabetic peripheral neuropathy. Quant Imaging Med Surg. 2019;9(2):273–82.

    Article  Google Scholar 

  22. Aslan M, Aslan A, Emeksiz HC, Candan F, Erdemli S, Tombul T, et al. Assessment of peripheral nerves with shear wave elastography in type 1 diabetic adolescents without diabetic peripheral neuropathy. J Ultrasound Med. 2019;38(6):1583–96.

    Article  Google Scholar 

  23. Tang X, Zhu B, Tian M, Guo R, Huang S, Tang Y, et al. Preliminary study on the influencing factors of shear wave elastography for peripheral nerves in healthy population. Sci Rep. 2021;11(1):5582.

    Article  CAS  Google Scholar 

  24. Arslan H, Yavuz A, İlgen F, Aycan A, Ozgokce M, Akdeniz H, et al. The efficiency of acoustic radiation force impulse (ARFI) elastography in the diagnosis and staging of carpal tunnel syndrome. J Med Ultrason (2001). 2018;45(3):453–9.

    Article  Google Scholar 

  25. Mohammadi A, Afshar A, Mirza-Aghazadeh-Attari M, Mokhtari SAS. Application of shear wave elastography and median nerve cross-section area in the diagnosis and staging of carpal tunnel syndrome: a case-control study. Pol J Radiol. 2021;86:e638–43.

    Article  Google Scholar 

  26. Abrishamchi F, Zaki B, Basiri K, Ghasemi M, Mohaghegh M. A comparison of the ultrasonographic median nerve cross-sectional area at the wrist and the wrist-to-forearm ratio in carpal tunnel syndrome. J Res Med Sci. 2014;19(12):1113–7.

    Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Hospital Sírio-Libanês, R. Adma Jafet, 91, São Paulo, 01308-050, Brazil

    Renato Antonio Sernik, Renata Fernandes Batista Pereira, Giovanni Guido Cerri, Rodrigo Sanford Damasceno, Breno Braga Bastos & Renata Vidal Leão

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  1. Renato Antonio Sernik
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  2. Renata Fernandes Batista Pereira
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  3. Giovanni Guido Cerri
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Correspondence to Renata Vidal Leão.

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Sernik, R.A., Pereira, R.F.B., Cerri, G.G. et al. Shear wave elastography is a valuable tool for diagnosing and grading carpal tunnel syndrome. Skeletal Radiol 52, 67–72 (2023). https://doi.org/10.1007/s00256-022-04143-0

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