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Ultrasound elastographic evaluation of the median nerve in hemodialysis with carpal tunnel syndrome

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Abstract

Purpose

The aim of this study was to compare the elasticity of the median nerve (MN) between hemodialysis (HD) patients without carpal tunnel syndrome (CTS) and with CTS, and to evaluate the diagnostic usefulness of the elasticity of the MN in HD-CTS.

Materials and methods

The MN in 22 HD patients without CTS and 49 HD-CTS patients was studied. The cross-sectional area (CSA) and the elasticity of the MN, which was measured as the subcutaneous fat/median nerve (SF/MN) strain ratio, were evaluated.

Results

The mean SF/MN strain ratio in the groups that had received hemodialysis for 0–5, >5–10, and >10–15 years was 1.4 ± 0.28, 1.7 ± 0.18, and 2.0 ± 0.67, respectively. The mean CSA of the MN in the three groups was 9.9 ± 1.30, 11.6 ± 1.61, and 13.4 ± 2.14 mm2, respectively. The presence of CTS was predicted by means of SF/MN strain ratio and CSA cutoff values of 1.8 and 11 mm2, respectively. Both the SF/MN strain ratio and the CSA in the patients with CTS were higher than those in the patients without CTS (P < 0.05). The sensitivity and specificity of the SF/MN strain ratio and CSA of the MN were 75 and 92 % and 79.2 and 84 %, respectively.

Conclusion

Sonoelastography helps to improve the diagnostic accuracy of the ultrasonographic assessment of CTS.

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Abbreviations

CTS:

Carpal tunnel syndrome

HD:

Hemodialysis

HD-CTS:

Hemodialysis with carpal tunnel syndrome

MN:

Median nerve

NCV:

Nerve conduction velocity

NCS:

Nerve conduction studies

DML:

Distal motor latency

MNCV:

Motor NCV

DSL:

Distal sensory latency

SF:

Subcutaneous fat

CSA:

Cross-sectional area

CI:

Confidence interval

ROC:

Receiver operating characteristic

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Authors and Affiliations

  1. Department of Ultrasonography, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, 250021, Shandong, People’s Republic of China

    Hua Xin & Xia Li

  2. Department of Geriatric, Shandong Provincial Qianfoshan Hospital, Shandong University, 16766 Jingshi Road, Jinan, 250014, Shandong, People’s Republic of China

    Hai-yang Hu

  3. Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Bin Liu

  4. Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, 250021, Shandong, People’s Republic of China

    Xiang Liu

  5. Department of Ultrasonography, Qilu Hospital of Shandong University, 107 Culture Road, Jinan, 250012, Shandong, People’s Republic of China

    Hua Xin & Jie Li

Authors
  1. Hua Xin
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  2. Hai-yang Hu
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  3. Bin Liu
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  4. Xiang Liu
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  5. Xia Li
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  6. Jie Li
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Corresponding author

Correspondence to Jie Li.

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Ethical statements

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from all patients for being included in the study. Additional informed consent was obtained from all patients for which identifying information is included in this article.

Conflict of interest

There are no financial or other relations that could lead to a conflict of interest.

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Xin, H., Hu, Hy., Liu, B. et al. Ultrasound elastographic evaluation of the median nerve in hemodialysis with carpal tunnel syndrome. J Med Ultrasonics 44, 123–131 (2017). https://doi.org/10.1007/s10396-016-0733-x

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  • DOI: https://doi.org/10.1007/s10396-016-0733-x

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