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ECR 2015 / B-0912
Can ultrasound replace MRI in assessment of nerve entrapment in osteofibrous tunnels in the upper extremity
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Congress: ECR 2015
Poster No.: B-0912
Type: Scientific Paper
Keywords: Extremities, Ultrasound, MR, Diagnostic procedure
Authors: A. Abdel Maguid, Y. M. Tohamey, T. Taymour, L. Adel; Cairo/EG
DOI:10.1594/ecr2015/B-0912

Results

All the cases included in the study presented by pain, 65% of cases had paresthesia in addition, 15% showed muscle wasting while 82.5% of the studied cases were diagnosed as carpal tunnel syndrome as shown in table 1.

 

Table (1): Distribution of the studied cases as regards the presenting symptoms

%

No

Variables

100%

40

Pain

65%

26

Paresthesia

15%

6

Muscle wasting

 

60%

40%

 

24

16

Side

Right

Left

 

82.5%

7.5%

7.5%

2.5%

 

33

3

3

1

Site

Carpal tunnel

Cubital

Suprascapular

Guyon’s

 

Regarding the electrophysiological studies results 35% of the studied cases were diagnosed as mild cases while 25% were diagnosed as severe cases as presented in table 2.

 

Table (2): Distribution of the studied cases as regards the results of electrophysiology

%

No

Variables

10%

4

Not done

35%

14

Mild

27.5%

11

Moderate

2.5%

1

Moderate to severe

25%

10

Severe

 

 Ultrasound was overall positive among 82.5% of the studied cases; while 17.5% of the studied cases were non positive (negative and border line cases) as presented in table 3.

 

 Table (3): Distribution of the studied cases as regard ultrasound results

%

No

Variables

94.6%

35

Decreased echogenicity

 

17.5%

82.5%

 

7

33

Conclusion

Non positive (negative-border line)

Positive

Range

Mean±SD

 

1.8-4.7

2.9±0.5

Flattening

2-6

4.2±1.08

Bowing

6.5-30

20.4±5.2

Cross sectional area

 

Positive MRI study represents 85% of the studied cases as presented in table 4.

 

Table (4): Distribution of the studied cases as regards MRI results

%

No

Variables

92.5%

37

Increased T2 signal

92.5%

37

Increased cross sectional area

15%

6

Muscle signal alteration

85%

34

Conclusion

Range

Mean±SD

 

1.6-4

2.8±0.6

Flattening

0.11-0.30

0.19±0.04

Bowing

 

Idiopathic etiology was found among 60% of the studied cases as presented in table 5.

 

Table (5): Distribution of the studied case as regards disease etiology

%

No

Variables

2.5%

1

Negative

60%

24

Idiopathic

37.5%

15

Extraneural compression

 

There was highly significant difference as regards bowing by using paired t-test. No significant difference was detected as regards flattening as presented in table 6.

  

Table (6): Comparison between U/S versus MRI as regards different measures

P

t

MRI

U/S

Variables

>0.05

NS

1.9

2.8±0.6

2.5±0.93

Flattening

<0.001

HS

3

0.19±0.04

4.4±1

Bowing

 

Highly significant association was identified between U/S versus MRI in the diagnosis of nerve entrapment by using paired Fisher exact test as presented in table 7.

 

Table (7): Comparison between U/S versus MRI as regards the diagnosis of nerve entrapment

P

MRI

Negative           Positive

U/S

<0.001

HS

3(7.5%)

 

4(10%)

Negative

31(77.5%)

 

2(5%)

Positive

 

Comparing the ultrasound results to the MRI, True positive results were present in 77.5% of the studied cases as presented in table 8

 

Table (8): Validity of U/S compared to MRI results

No  

Validity

31

T+ve

4

T-ve

2

F+ve

3

F-ve

 

 Ultrasound shows high positive predictive value 89%, sensitivity 91% and overall accuracy 87.5% but shows low negative predictive value 58% and specificity 67% in diagnosis of nerve entrapment as presented in table 9.

 

 

Table (9) Validity variables of U/S versus MRI results among the studied cases 

 

%

Validity variables

91%

Sensitivity

67%

Specificity

89%

Positive predictive value

58%

Negative predictive value

87.5%

Overall accuracy

 

 

Representative cases are shown in Fig 1-4

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