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conferenceseries
.com
Volume 3
October 03-04, 2018 Osaka, Japan
Pediatric Neurology & Medicine
3
rd
International conference on
N
euroscience
, N
euroradiology
and
I
maging
Neuroimaging 2018
October 03-04, 2018
J Pediatr Neurol Med 2018, Volume 3
DOI: 10.4172/2472-100X-C1-003
Separation of carpal tunnel syndrome associated with axonal degeneration using via ratio of carpal
tunnel outlet readings by ultrasound
Deng Xue, Chau Lai-Heung, Chiu Suk-Yee, Leung Kwok Pui, Li Sheung-Wai and Ip Wing-Yuk
The University of Hong Kong, Hong Kong
N
erve Conduction Studies (NCS) and Ultra Sonography (US) have been cross-validated for diagnostic confirmation and
gradation of severity of the Carpal Tunnel Syndrome (CTS), amedian nerve compression injury at the wrist. However, NCS
cannot differentiate the CTS with demyelination alone from the disease with secondary axonal degeneration. Yet it is unknown
if Ultrasound (US) can compensate this deficit. This study aimed at exploring US to differentiate CTS with demyelination
only from that in association with axonal degeneration. We studied 39 demyelinated CTS hands and 154 demyelinated CTS
hands with axonal degeneration in sensory median nerves by comparing Cross-Sectional Area (CSA-W) and Perimeter (P-
W) of median nerve at wrist, ratio of CSA (R-CSA) and P(R-P) of wrist over mid-forearm measured by US. Results revealed
significant differences in R-CSA (p=0.013) and R-P (p=0.05) while descriptive differences in CSA-W and P-W. ROC curves
indicated significant accuracy of R-CSA (Area=0.62, p=0.015) and R-P (Area=0.615, p=0.02). The cut-off value of R-CSA to
indicate CTS associated with axonal degeneration is 1.8 with sensitivity of 71% and specificity of 45% while 1.5 for R-P with
sensitivity of 70% and specificity of 43%. Our findings were consistent with previous relevant studies and the result would be
more robust should more cases be enrolled. We conclude that US may be potentially used to differentiate demyelinated CTS
from that with axonal degeneration in clinical practice. This finding can improve diagnostic efficiency in clinical practice and
help patients to choose appropriate treatment.
dannytang023@gmail.com