Location of Repository

Síndrome do túnel do carpo: estudo comparativo entre a medição ultrassonográfica e cirúrgica do nervo mediano nos casos moderados e severos da doença Carpal tunnel syndrome: comparative study between sonographic and surgical measurements of the median nerve in moderate and severe cases of disease

By Marcelo de Pinho Teixeira Alves, Clovis Orlando Pereira da Fonseca, José Mauro Granjeiro, Paulo Roberto Gonçalves de Souza and Marcos Tzirulnik

Abstract

OBJETIVO: Comparar os perímetros ultrassonográfico e cirúrgico do nervo mediano, avaliar o diagnóstico da síndrome do túnel do carpo pela área seccional do nervo mediano, verificar associação entre área seccional do nervo mediano e gravidade da síndrome do túnel do carpo. MATERIAIS E MÉTODOS: Estudo de 30 pacientes com síndrome do túnel do carpo. Mediram-se a área seccional e o perímetro ultrassonográfico do nervo mediano. Avaliaram-se correlação clínica-ultrassonográfica e associação com a gravidade da doença. Compararam-se os perímetros ultrassonográfico e cirúrgico. Compararam-se classificação clínica com perímetro cirúrgico, área seccional e perímetro ultrassonográfico. RESULTADOS: Cinco perdas, 25 pacientes estudados; 60% dos pacientes com doença moderada, 60% de casos graves ultrassonográficos (área seccional > 0,15 cm²). Distribuição não normal de perímetro cirúrgico (p = 0,5), distribuição normal de perímetro ultrassonográfico (p = 0). Diferença significativa entre perímetros (teste-t de amostras pareadas; p < 0,0001; intervalo de confiança = 95%). Pearson 0,3913. Pelo diagrama de Bland-Altman, observaram-se maiores perímetros cirúrgicos. Encontrou-se área seccional do nervo mediano > 0,09 cm² em todos os pacientes. CONCLUSÃO: Não houve associação entre perímetro ultrassonográfico e perímetro cirúrgico do nervo mediano. Área seccional do nervo mediano > 0,09 cm² foi válida para o diagnóstico. Não houve associação entre área seccional e gravidade da doença.<br>OBJECTIVE: To compare sonographic and surgical measured perimeters of the median nerve; to evaluate the diagnosis of carpal tunnel syndrome by median nerve cross-sectional area; to verify the association between cross-sectional area of the median nerve and carpal tunnel syndrome severity. MATERIALS AND METHODS: Thirty patients with established carpal tunnel syndrome were studied. Cross-sectional area and sonographic perimeter of the median nerve were measured. The correlation between clinical and sonographic findings and association with carpal tunnel syndrome severity were evaluated. Sonographic and surgical perimeters were compared. Clinical classification, surgical perimeter, cross-sectional area and sonographic perimeter of the median nerve were compared. Statistical analysis utilized paired samples t-test, Pearson's correlation, Bland-Altman's diagram, Kolmogorov-Smirnov's test, Welch's and Wilcoxon's tests. RESULTS: Five patients were excluded; 25 patients were studied; 60% of patients had moderated disease, and 60% presented cross-sectional area > 0.15 cm². Distribution of surgical perimeter was not normal (p = 0.5); the sonographic perimeter distribution was normal (p = 0). There was a statistically significant difference between perimeters (paired samples t-test, p < 0.0001, confidence interval = 95%). Pearson's correlation corresponded to 0.3913. Bland-Altman diagram demonstrated higher values for surgical perimeters. Median nerve cross-sectional area > 0.09 cm² was found in all the patients. CONCLUSION: No association was observed between median nerve sonographic and surgical perimeters. Median nerve cross-sectional area > 0.09 cm² was valid for diagnosis of carpal tunnel syndrome. No association was observed between median nerve cross-sectional area and carpal tunnel syndrome severity

Topics: Síndrome do túnel do carpo, Ultrassonografia, Diagnóstico, Neuropatia, Carpal tunnel syndrome, Ultrasonography, Diagnosis, Neuropathy, Medical physics. Medical radiology. Nuclear medicine, R895-920, Medicine (General), R5-920, Medicine, R, DOAJ:Internal medicine, DOAJ:Medicine (General), DOAJ:Health Sciences
Publisher: Colégio Brasileiro de Radiologia e Diagnóstico por Imagem
Year: 2013
OAI identifier: oai:doaj.org/article:47f49cfad4134f8ab61bca5d929d8a17
Journal:
Download PDF:
Sorry, we are unable to provide the full text but you may find it at the following location(s):
  • https://doaj.org/toc/1678-7099 (external link)
  • https://doaj.org/toc/0100-3984 (external link)
  • http://www.scielo.br/scielo.ph... (external link)
  • https://doaj.org/article/47f49... (external link)
  • Suggested articles


    To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.