title: Color and power Doppler US for diagnosing carpal tunnel syndrome and determining its severity: a quantitative image processing method.
abstract: OBJECTIVE
  To determine whether intraneural vascularity seen at color Doppler ultrasonography (US) can be used to diagnose carpal tunnel syndrome (CTS) and to evaluate an image processing method for quantifying the severity of CTS on the basis of this vascularity.
  
  
  METHODS
  This study was approved by the university ethics review committee. One hundred one patients with clinical evidence of CTS and 55 healthy control subjects were enrolled. Electrodiagnostic testing (EDT) was performed in all participants, and the presence of intraneural vascularity was evaluated with color Doppler US. An image processing program was designed by using software to determine the sum of pixels in the intraneural vascular area on power Doppler US scans of the median nerve. The relationship between the number of pixels and the severity of the abnormality at EDT was determined.
  
  
  RESULTS
  The sensitivity (83%) and specificity (89%) of intraneural vascularity in the diagnosis of CTS were similar to those of EDT (81% and 84%, respectively). Intraneural vascularity was seen in 91.4% of patients with mild CTS and 100% of patients with moderate or severe CTS. In participants with positive intraneural vascularity, the sum of pixels in the intraneural vascular area was significantly higher in patients than in control subjects and paralleled the severity of the abnormality at EDT (P < .01).
  
  
  CONCLUSIONS
  Color Doppler US can be used to accurately diagnose CTS. By processing the recorded power Doppler images and determining the number of pixels in the intraneural vascular area, the severity of CTS can be assessed. 2011 SUPPLEMENTAL MATERIAL: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11110150/-/DC1.
authors: Advanced Diagnostic and Interventional Radiology Research Center, Imam Hospital, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran 13145-784, Iran.
authors: Ahmad Reza
authors: AR
authors: Ghasemi-Esfe
authors: Omid
authors: O
authors: Khalilzadeh
authors: Seyed Mehran
authors: SM
authors: Vaziri-Bozorg
authors: Mahdie
authors: M
authors: Jajroudi
authors: Madjid
authors: M
authors: Shakiba
authors: Mehdi
authors: M
authors: Mazloumi
authors: Maryam
authors: M
authors: Rahmani
mesh_terms: D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004568:Electrodiagnosis; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008475:Median Nerve / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018608:Ultrasonography, Doppler / Q000379:methods*; D018615:Ultrasonography, Doppler, Color