Utilizing Doppler Ultrasound to Detect Arteriole Blood Flow Within the Median Nerve Sheath
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Publisher:The Ohio State University
Series/Report no.:The Ohio State University. School of Allied Medical Professions Honors Theses; 2010
Diagnostic medical sonographers (DMS) are at an increased risk for developing work-related musculoskeletal disorders, such as carpal tunnel syndrome (CTS). CTS is characterized by inflammation of the median nerve within the carpal tunnel and a literature review supports that hypervascularization is seen within the nerve sheath. Currently, only invasive procedures such as nerve conduction testing and dynamic contrast magnetic resonance imaging are utilized in diagnosing CTS. This feasibility study was the first of its kind to detect and quantify arteriole blood flow within the median nerve with spectral and power Doppler ultrasound. Five DMS had their wrists scanned with a hand carried ultrasound unit over a 10-week period both before and after scanning neonatal heads. The results showed the qualitative measure of blood flow with color Doppler was consistently seen on each scanning session, whereas the quantitative measure with spectral Doppler was obtained only half of the time. The pre and post measures of peak systolic (PS) velocity and end diastolic (ED) velocity were not statistically significant, but showed very low blood flow on average - PS = 4.36 cm/s and ED = 0.76 cm/s. While these measures were not consistently obtained, this study proved acquiring quantitative blood flow within the median nerve with spectral Doppler ultrasound is feasible. There were many limitations of this study and key among these was the short evaluation, nested inside a larger work day. This was a feasibility study; therefore a more rigorous controlled study is needed to find the true sensitivity of spectral Doppler ultrasound to quantify blood flow in the median nerve. A longitudinal and comprehensive data collection is needed that reflects the entire work load. Therefore, this research underlines the importance of understanding the related physiology and technique to find a noninvasive alternative in diagnosing CTS.