{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"omics_type":["Unknown"],"volume":["12(11)"],"submitter":["Falsetti P"],"pubmed_abstract":["Background
There is little consensus on ultrasound (US) normative values of cross-sectional area of median nerve (MN-CSA) in carpal tunnel syndrome (CTS) because of its dependency on anthropometric parameters. We aim to propose a novel anthropometric-independent US parameter: MN-CSA/flexor radialis carpi CSA (FCR-CSA) ratio (\"Nerve Tendon Ratio\", NTR), in the diagnosis of clinically and electrodiagnostic (EDS)-defined CTS.Methods
74 wrists of 49 patients with clinically defined CTS underwent EDS (scored by the 1-5 Padua Scale of electrophysiological severity, PS) and US of carpal tunnel with measurement of MN-CSA (at the carpal tunnel inlet), FCR-CSA (over scaphoid tubercle) and its ratio (NTR, expressed as a percentage). US normality values and intra-operator agreement were assessed in 33 healthy volunteers.Results
In controls, the mean MN-CSA was 5.81 mm2, NTR 64.2%. In 74 clinical CTS, the mean MN-CSA was 12.1 mm2, NTR 117%. In severe CTS (PS > 3), the mean MN-CSA was 15.9 mm2, NTR 148%. In CTS, both MN-CSA and NTR correlated with sensitive conduction velocity (SCV) (p < 0.001), distal motor latency (DML) (p < 0.001) and PS (p < 0.001), with a slight superiority of NTR vs. MN-CSA when controlled for height, wrist circumference and weight. In CTS filtered for anthropometric extremes, only NTR maintained a correlation with SCV (p = 0.023), DML (p = 0.016) and PS (p = 0.009). Diagnostic cut-offs were obtained with a binomial regression analysis. In those patients with a clinical diagnosis of CTS, the cut-off of MN-CSA (AUROC: 0.983) was 8 mm2 (9 mm2 with highest positive predictive value, PPV), while for NTR (AUROC: 0.987), the cut-off was 83% (100% with highest PPV). In patients with EDS findings of severe CTS (PS > 3), the MN-CSA (AUROC: 0.876) cut-off was 12.3 mm2 (15.3 mm2 with highest PPV), while for NTR (AUROC: 0.858) it was 116.2% (146.0% with highest PPV).Conclusions
NTR can be simply and quickly calculated, and it can be used in anthropometric extremes."],"journal":["Diagnostics (Basel, Switzerland)"],"pagination":["2621"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC9689936"],"repository":["biostudies-literature"],"pubmed_title":["A Novel Ultrasonographic Anthropometric-Independent Measurement of Median Nerve Swelling in Carpal Tunnel Syndrome: The \"Nerve/Tendon Ratio\" (NTR)."],"pmcid":["PMC9689936"],"pubmed_authors":["Conticini E","Gentileschi S","Cantarini L","Acciai C","Frediani B","Ginanneschi F","Bardelli M","D'Alessandro R","Falsetti P","D'Alessandro M","Baldi C","D'Ignazio E","Al Khayyat SG"],"additional_accession":[]},"is_claimable":false,"name":"A Novel Ultrasonographic Anthropometric-Independent Measurement of Median Nerve Swelling in Carpal Tunnel Syndrome: The \"Nerve/Tendon Ratio\" (NTR).","description":"Background
There is little consensus on ultrasound (US) normative values of cross-sectional area of median nerve (MN-CSA) in carpal tunnel syndrome (CTS) because of its dependency on anthropometric parameters. We aim to propose a novel anthropometric-independent US parameter: MN-CSA/flexor radialis carpi CSA (FCR-CSA) ratio (\"Nerve Tendon Ratio\", NTR), in the diagnosis of clinically and electrodiagnostic (EDS)-defined CTS.Methods
74 wrists of 49 patients with clinically defined CTS underwent EDS (scored by the 1-5 Padua Scale of electrophysiological severity, PS) and US of carpal tunnel with measurement of MN-CSA (at the carpal tunnel inlet), FCR-CSA (over scaphoid tubercle) and its ratio (NTR, expressed as a percentage). US normality values and intra-operator agreement were assessed in 33 healthy volunteers.Results
In controls, the mean MN-CSA was 5.81 mm2, NTR 64.2%. In 74 clinical CTS, the mean MN-CSA was 12.1 mm2, NTR 117%. In severe CTS (PS > 3), the mean MN-CSA was 15.9 mm2, NTR 148%. In CTS, both MN-CSA and NTR correlated with sensitive conduction velocity (SCV) (p < 0.001), distal motor latency (DML) (p < 0.001) and PS (p < 0.001), with a slight superiority of NTR vs. MN-CSA when controlled for height, wrist circumference and weight. In CTS filtered for anthropometric extremes, only NTR maintained a correlation with SCV (p = 0.023), DML (p = 0.016) and PS (p = 0.009). Diagnostic cut-offs were obtained with a binomial regression analysis. In those patients with a clinical diagnosis of CTS, the cut-off of MN-CSA (AUROC: 0.983) was 8 mm2 (9 mm2 with highest positive predictive value, PPV), while for NTR (AUROC: 0.987), the cut-off was 83% (100% with highest PPV). In patients with EDS findings of severe CTS (PS > 3), the MN-CSA (AUROC: 0.876) cut-off was 12.3 mm2 (15.3 mm2 with highest PPV), while for NTR (AUROC: 0.858) it was 116.2% (146.0% with highest PPV).Conclusions
NTR can be simply and quickly calculated, and it can be used in anthropometric extremes.","dates":{"release":"2022-01-01T00:00:00Z","publication":"2022 Oct","modification":"2025-04-19T16:10:24.735Z","creation":"2025-02-19T01:56:43.27Z"},"accession":"S-EPMC9689936","cross_references":{"pubmed":["36359465"],"doi":["10.3390/diagnostics12112621"]}}