Ulnar Nerve Cross-Sectional Area for the Diagnosis of Cubital Tunnel Syndrome: A Meta-Analysis of Ultrasonographic Measurements
Ulnar Nerve Cross-Sectional Area for the Diagnosis of Cubital Tunnel Syndrome: A Meta-Analysis of Ultrasonographic Measurements
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DOI：
10.1016/j.apmr.2017.08.467
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发表时间：
2018-04-01
影响因子：
4.3
通讯作者：
Ozcakar, Levent
中科院分区：
文献类型：
--
作者：
Chang, Ke-Vin;Wu, Wei-Ting;Ozcakar, Levent
目的：探讨超声截面积(CSA)测量在肘管综合征(Cuts)诊断中的作用。资料来源：检索PubMed和EMBASE电子数据库2017年7月1日以前的相关文献。资料选择：比较肘管综合征患者尺神经截面积测量的14项试验。资料提炼：研究设计、受试者的人口学特征、截骨的诊断依据和CSA的测量方法。资料综合：在不同肘关节水平上，CSA的组间差异最大(6.0 mm(2)；95%可信区间[CI]，4.5-7.4 mm(2))。未切开的受试者的CSA在上臂水平为5.5 mm(2)(95%CI，4.4~6.6 mm(2))，在肘管入口为7.4 mm(2)(95%CI，6.7~8.1 mm(2))，在内上髁为6.6 mm(2)(95%CI，5.9~7.2 mm(2))，在肘管出口为7.3 mm(2)(95%CI，5.6~9.0 mm(2))，前臂水平5.5 mm(2)(95%可信区间，4.7~6.3 mm(2))。以10 mm(2)为分界点的5项研究的敏感性、特异性和诊断优势比分别为.85(95%CI，0.78-.90)、.91(95%CI，0.86-.94)和53.96(95%CI，14.84-196.14)。由于健康受试者在不同位置的尺神经CSA很少超过10 mm(2)，该值可被认为是诊断肘部尺神经卡压的一个截断点。(C)2017年美国康复医学大会
Objective: To examine the performance of sonographic cross-sectional area (CSA) measurements in the diagnosis of cubital tunnel syndrome (CuTS).Data Sources: Electronic databases, comprising PubMed and EMBASE, were searched for the pertinent literature before July 1, 2017.Study Selection: Fourteen trials comparing the ulnar nerve CSA measurements between participants with and without CuTS were included.Data Extraction: Study design, participants' demographic characteristics, diagnostic reference of CuTS, and methods of CSA measurement.Data Synthesis: Among different elbow levels, the between-group difference in CSA was the largest at the medial epicondyle (6.0mm(2); 95% confidence interval [CI], 4.5-7.4mm(2)). The pooled mean CSA in participants without CuTS was 5.5mm(2) (95% CI, 4.4-6.6mm(2)) at the arm level, 7.4mm(2) (95% CI, 6.7-8.1mm(2)) at the cubital tunnel inlet, 6.6mm(2) (95% CI, 5.9-7.2mm(2)) at the medial epicondyle, 7.3mm(2) (95% CI, 5.6-9.0mm(2)) at the cubital tunnel outlet, and 5.5mm(2) (95% CI, 4.7-6.3mm(2)) at the forearm level. The sensitivities, specificities, and diagnostic odds ratios pooled from 5 studies, using 10mm(2) as the cutoff point, were .85 (95% CI, .78-.90), .91 (95% CI, .86-.94), and 53.96 (95% CI, 14.84-196.14), respectively.Conclusions: The ulnar nerve CSA measured by ultrasound imaging is useful for the diagnosis of CuTS and is most significantly different between patients and participants without CuTS at the medial epicondyle. Because the ulnar nerve CSA in healthy participants, at various locations, rarely exceeds 10mm(2), this value can be considered as a cutoff point for diagnosing ulnar nerve entrapment at the elbow region. (C) 2017 by the American Congress of Rehabilitation Medicine