Grey-scale sonography and sonoelastography for diagnosing carpal tunnel syndrome

Table 1 Summary of previous studies reporting the diagnostic value of the median nerve cross-sectional area in carpal tunnel syndrome

Ref.	CSA cut-off (mm2)	CTS wrists	Control wrists	Location	Sensitivity (%)	Specificity (%)	AUC
Duncan et al[47]	9	102	68	Pisiform	82	97	NA
Lee et al[48]	15	100	56	Scaphoid tuberosity and the pisiform	88	96	NA
Sarría et al[26]	11	64	42	Hook of hamate	75	57	NA
Swen et al[49]	10	63	20	Pisiform	70	63	NA
Nakamichi and Tachibana[50]	12	414	408	Mean location of the proximal, mid and distal tunnel	67	97	NA
Wong et al[51]	9.8	35	35	Tunnel inlet	89	83	0.91
Kele et al[52]	11	110	55	Tunnel inlet	74	98	NA
Altinok et al[53]	9	40	40	Pisiform	65	93	NA
El Miedany et al[54]	10	96	156	Tunnel inlet	98	100	NA
Keleş et al[55]	9.3	35	40	Middle carpal tunnel	80	76	0.833
Ziswiler et al[56]	10	78	23	The largest CSA	82	87	0.89
Mallouhi et al[57]	11	172	None	Maximal CSA in the carpal tunnel	91	47	NA
Wiesler et al[58]	11	44	86	The distal wrist crease	91	84	NA
Naranjo et al[59]	9.7	80	25	Tunnel inlet	86	48	0.78
Kaymak et al[60]	12	34	38	Pisiform	88	66	0.84
Kwon et al[61]	10.7	41	41	Tunnel inlet	66	63	0.75
Pinilla et al[62]	6.5	40	30	Tunnel inlet	89.5	93	NA
Sernik et al[28]	10	40	63	Pisiform	85	92.1	NA
Visser et al[63]	10	265	137	Tunnel inlet	78	91	0.90
Ashraf et al[64]	9.3	70	80	Middle carpal tunnel	80	77.5	0.796
Klauser et al[18]	12	100	93	Maximal CSA in the carpal tunnel	94	95	0.9896
Pastare et al[65]	9	97	None	Tunnel inlet	62	100	0.842
Mohammadi et al[66]	8.5	132	32	Tunnel inlet	97	98	NA
Ghasemi-Esfe et al[29]	10.5	85	49	Pisiform	69	94	NA
Roll et al[19]	10.3	83	83	Pisiform	80.4	90.6	0.899
Kang et al[23]	9.5	110	38	Distal wrist crease	96	92	0.988
Ulaşli et al[67]	10.5	95	48	Maximal CSA in the carpal tunnel	91	81	0.934
Fowler et al[42]	10	55	30	Pisiform	89	90	NA
Kantarci et al[35]	9.5	60	36	Tunnel inlet	60	91.7	0.844
Miyamoto et al[37]	11	43	44	Pisiform	82	75	0.85
Ooi et al[68]	9.8	95	30	Pisiform	92	90	0.95

CSA: Cross-sectional area; CTS: Carpal tunnel syndrome; AUC: Area under curve; NA: Not available.

Table 2 Summary of studies reporting the diagnostic value of the delta cross-sectional area of the median nerve for carpal tunnel syndrome

Ref.	delta CSA cut-off (mm2)	CTS wrists	Control wrists	Location	Sensitivity (%)	Specificity (%)	AUC
Klauser et al[18]	2	100	93	Maximal CSA in the carpal tunnel/proximal third of the pronator quadratus	99	100	0.9988
Roll et al[19]	4.16	83	83	Pisiform/6 cm proximal to the distal wrist crease	82.4	87.5	0.886
Tajika et al[20]	2	50	81	Pisiform/distal radioulnar joint	100	99	0.996

CSA: Cross-sectional area; CTS: Carpal tunnel syndrome; AUC: Area under curve.

Table 3 Summary of studies reporting the diagnostic value of the cross-sectional area ratio of the median nerve for carpal tunnel syndrome

Ref.	CSA ratio cut-off	CTS wrists	Control wrists	Location	Sensitivity (%)	Specificity (%)	AUC
Hobson-Webb et al[21]	1.4	44	18	Distal wrist crease/12 cm proximal in the forearm	100	NA	NA
Visser et al[22]	2	265	137	Tunnel inlet/forearm	69	90	0.83
Roll et al[19]	1.70	83	83	Pisiform/6 cm proximal to the distal wrist crease	80.4	81.2	0.842
Kang et al[23]	1.34	110	38	Distal wrist crease/12 cm proximal in the forearm	99.9	100	0.988
Mhoon et al[24]	1.4	192	50	Distal wrist crease/12 cm proximal in the forearm	97	28	0.789
Fu et al[25]	1.3	46	44	Tunnel inlet/outlet	91	93	0.98

CSA: Cross-sectional area; CTS: Carpal tunnel syndrome; AUC: Area under curve; NA: Not available.

Table 4 Summary of studies reporting the diagnostic accuracy for carpal tunnel syndrome of the median nerve elasticity determined using sonoelastography

Ref.	Type of sonoelastography	CTS wrists	Control wrists	Location	Sensitivity (%)	Specificity (%)	AUC
Orman et al[36]	Compression	74	45	Pisiform-scaphoid	84	54	NA
Miyamoto et al[37]	Compression	43	44	Pisiform-scaphoid	82	68	0.78
Kantarci et al[35]	Shear wave	60	36	Tunnel inlet	93.3	88.9	0.956

CTS: Carpal tunnel syndrome; AUC: Area under curve; NA: Not available.