Diagnostic value of high-frequency ultrasonography in testing carpal canal structure in patients with occupational hand-arm vibration disease / 中国职业医学

ABSTRACT

OBJECTIVE: To evaluate the clinical value of high-frequency ultrasonagraphy in testing carpal canal structure in the diagnosis of patients with occupational hand-arm vibration disease( HAVD). METHODS: Eighteen patients with occupational mild HAVD( 36 wrists) were selected as the case group and 20 healthy volunteers( 40 wrists) were enrolled as the control group by using convenience sampling method. The color doppler ultrasound was used to measure the crosssectional areas( CSA) of median nerve at the level of pisiform bone,the thickness of transverse carpal ligament,and the internal diameter of median nerve and the CSA of median nerve at the level of hamate hook of the 2 groups. Fisher discriminant analysis and receiver operating characteristic( ROC) curve were performed to assess the effect of diagnosing HAVD with the CSA of median nerve at the level of pisiform bone in patients with HAVD. RESULTS: The CSA of median nerve at the level of pisiform bone in both hands was smaller than that of the control group( P < 0. 01). However,there was no statistical significance in the thickness of transverse carpal ligament of both hands,the internal diameter of median nerve and the CSA of median nerve at the level of hamate hook in the case and control groups( P > 0. 05). Through the Fisher discriminant analysis which was carried on and the distinction equation which was established meanwhile by using the CSA of median nerve at the level of pisiform bone in both hands as HAVD diagnostic criterion,the HAVD predictive accuracy rate was 78. 9%. The ROC curve was underway with the discriminant score as an indicator for distinguishing HAVD,and the result showed that the area under the curve was 0. 842,with sensitivity of 75. 00% and specificity of 88. 90%. CONCLUSION: High-frequency ultrasonography can be used to observe and quantify the imaging changes of carpal canal structure in patients with HAVD,which can provide objective and scientific diagnostic basis for the diagnosis of HAVD.