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| Diagnostic Usefulness of Ultrasonographic Examination of Cubital Tunnel Syndrome: Analysis of Ulnar Nerve Cross-sectional Area |
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| Yu Mee Sohn, M.D. Suk-Joo Hong, M.D., Joon Shik Yoon, M.D.*, Cheol Min Park, M.D., Jung Hyuk Kim, M.D.** |
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| Department of Radiology, Korea University Guro Hospital *Department of Rehabilitation Medicine, Korea University Guro Hospital **Department of Radiology, Korea University Auam Hospital |
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| PURPOSE : To prospectively evaluate the accuracy of sonography for diagnosis of cubital tunnel syndrome (CUTS)
confirmed by electrodiagnostic study.
MATERIALS and METHODS : From February 2004 to March 2005, we prospectively analyzed 24 elbows in 19 patients
(8 women, 11 men; mean age, 49.2 years; range 23-65 years) with cubital tunnel syndrome, including 5 bilateral
cases. Diagnoses of CUTS were confirmed by both clinical symptom and electrodiagnostic study.
Sonographic findings of 20 asymptomatic cases served as controls. In sonographic examination, the cross sectional
area of the ulnar nerve was measured at the inlet (at the level of medial epicondyle) and outlet (at the level
of convergence of flexor carpi ulnaris tendons) of the cubital tunnel. The shape and echogenicity of the ulnar nerve
were also evaluated, as were possible causes of entrapment. The accuracy of using ultrasonographic cross
sectional area to diagnose CUTS was evaluated with receiver operating characteristic (ROC) analysis.
RESULTS : The cross sectional area of the ulnar nerve at the inlet and outlet levels in CUTS patients was increased
much more than in the asymptomatic cases. Decreased echogenicity and distortion of normal parallel echotexture
of the ulnar nerve were observed in all CUTS patients. At the inlet level, the area under the ROC curve
(AUC) was 0.816, and the ideal cut-off value for CUTS diagnosis was 0.08 ㎠ with a sensitivity of 58.3%,
specificity of 100%, positive predictive value (PPV) of 100%, and negative predictive value (NPV) of 66.7%.
At the distal outlet level, the AUC was 0.785, and the cut-off value was 0.06 ㎠ with a sensitivity of 79.2%,
specificity of 70%, PPV of 76%, and NPV of 73.7%. When the summation value of inlet and outlet cross sectional
areas was used, the AUC was 0.853, and cut-off value was 0.14 ㎠ with a sensitivity of 70.8%, specificity
of 85%, PPV of 85%, and NPV of 70.8%.
CONCLUSION : Measurement of the cross sectional area of the ulnar nerve at the inlet and outlet of the cubital tunnel
can aid in the sonographic diagnosis of cubital tunnel syndrome by more objectively determining the increase in
cross sectional area. |
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| Keyword : Ultrasound (US) Nerves, peripheral Nerves, diseases |
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pdf파일 : 087-92손유미.pdf 
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> Journal > Journal Search 
Journal of Korean Society of Ultrasound in Medicine 2006 ; 25 (2) : p.87-92
