title: Ultrasound elastographic evaluation of the median nerve in hemodialysis with carpal tunnel syndrome.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  Sonoelastography helps to improve the diagnostic accuracy of the ultrasonographic assessment of CTS.
authors.affiliation: Department of Ultrasonography, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, 250021, Shandong, People's Republic of China.|Department of Ultrasonography, Qilu Hospital of Shandong University, 107 Culture Road, Jinan, 250012, Shandong, People's Republic of China.
authors.forename: Hua
authors.initials: H
authors.lastname: Xin
authors.affiliation: Department of Geriatric, Shandong Provincial Qianfoshan Hospital, Shandong University, 16766 Jingshi Road, Jinan, 250014, Shandong, People's Republic of China.
authors.forename: Hai-Yang
authors.initials: HY
authors.lastname: Hu
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Bin
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, 250021, Shandong, People's Republic of China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Ultrasonography, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, 250021, Shandong, People's Republic of China.
authors.forename: Xia
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Ultrasonography, Qilu Hospital of Shandong University, 107 Culture Road, Jinan, 250012, Shandong, People's Republic of China. jieli301@163.com.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008875:Middle Aged; D009431:Neural Conduction; D011446:Prospective Studies; D006435:Renal Dialysis; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
keywords: Carpal tunnel syndrome; Hemodialysis; Ultrasound; Ultrasound elastography