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Predictors of Carpal Tunnel Syndrome: Accuracy of Gray-Scale and Color Doppler Sonography

Ammar Mallouhi1, Petra Pültzl2, Thomas Trieb3, Hildgunde Piza2 and Gerd Bodner3

1 Department of Radiology II, Innsbruck University Hospital, Anichstrasse 35, Innsbruck 6020, Austria.
2 Department of Plastic Surgery, Innsbruck University Hospital, Innsbruck, Austria.
3 Department of Radiology I, Kurt Amplatz Center, Innsbruck University Hospital, Innsbruck, Austria.


Figure 1
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  		Fig. 1A —72-year-old woman with nerve conduction studies and surgically proven carpal tunnel syndrome. Gray-scale sonogram at carpal tunnel inlet depicts mild swelling of median nerve (arrows) with cross-sectional area of 0.11 cm2 in addition to severe nerve edema and slight palmar bowing of flexor retinaculum (arrowheads).

 

Figure 2
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  		Fig. 1B —72-year-old woman with nerve conduction studies and surgically proven carpal tunnel syndrome. Transverse (B) and longitudinal (C) color Doppler sonograms at carpal tunnel inlet show intraneural abnormal vasculature (arrows).

 

Figure 3
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  		Fig. 1C —72-year-old woman with nerve conduction studies and surgically proven carpal tunnel syndrome. Transverse (B) and longitudinal (C) color Doppler sonograms at carpal tunnel inlet show intraneural abnormal vasculature (arrows).

 

Figure 4
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  		Fig. 1D —72-year-old woman with nerve conduction studies and surgically proven carpal tunnel syndrome. Spectral Doppler waveform of intraneural vascular structure indicates presence of arterial flow in nerve.

 

Figure 5
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  		Fig. 2A —67-year-old man with nerve conduction studies and surgically proven carpal tunnel syndrome. Gray-scale sonogram at carpal tunnel inlet depicts normal median nerve (arrows) with cross-sectional area of 0.09 cm2 and no evidence of nerve edema or increased palmar bowing of flexor retinaculum.

 

Figure 6
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  		Fig. 2B —67-year-old man with nerve conduction studies and surgically proven carpal tunnel syndrome. Transverse color Doppler sonogram at carpal tunnel inlet shows intraneural abnormal vasculature (arrows), an advantage of color Doppler over gray-scale sonography.

 

Figure 7
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  		Fig. 3A —40-year-old woman with negative results of nerve conduction studies. Gray-scale sonogram at carpal tunnel inlet depicts median nerve swelling with cross-sectional area of 0.15 cm2, nerve edema, and palmar bowing of flexor retinaculum. Area inside dotted oval is region of interest.

 

Figure 8
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  		Fig. 3B —40-year-old woman with negative results of nerve conduction studies. Transverse color Doppler sonogram at carpal tunnel inlet reveals no intraneural abnormal vasculature, thus correlating with nerve conduction studies better than gray-scale sonography correlated with those studies.

 

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