Utilizing contrast-enhanced ultrasound for the detection of perineural trauma and associated hypervascularity of the median nerve: A small cohort study.
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Date
2013-05
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Publisher
The Ohio State University
Abstract
This small cohort study was conducted to determine, by way of contrast-enhanced ultrasound (CEUS), if there is a quantifiable vascular difference in patients affected with carpal tunnel syndrome (CTS) symptoms versus patients who are not affected by the disease's symptoms. The clinical translation of this study was to identify CEUS as a novel diagnostic tool for the detection and evaluation of CTS and encourage the FDA approval of CEUS studies in the U.S. medical field.
Ultrasound equipment settings and dosing were optimized to provide consistent CEUS imaging. The contrast dosing amounts were determined at the discretion of the lead echo sonographer and varied in both dosing amount and number of dosing injections. UCA dosing amounts varied from 3 ml (Patient 1) to 5 ml (Patient 5), with a mean dose of 3.33 ml over all patients. The contrast solution for all subjects contained 1.3 ml of Definity® to 8.7 ml of saline. In addition, the equipment parameters were maintained at 4% output power and a mechanical index (MI) of 0.13. The transmit frequency of the linear transducer was held at a constant of 9 MHz throughout the trials.
The use of an image analysis software program was employed to quantiitize the amount of perinueral vascularity. An interclass correlation coefficient (ICC) was calculated between the investigators for manual signal counts and Iavg within the ROI to determine user reliability. Chronbach's alpha for signal counts and Iavg were 0.90 and 0.80 and ICCs were 0.90 (p< 0.01) and 0.80 (p<0.01), respectively.
This clinical study confirmed successful equipment settings and image analysis that allowed for a valid and reliable demonstration of vascularity surrounding the human median nerve; furthermore, the study found a qualitative difference in the vascularity of asymptomatic versus symptomatic median nerves.
Description
This research was presented at the Society of Diagnostic Medical Sonographers (SDMS) annual conference in Seattle WA, presented as a scientific lecture at the Ohio Medical Ultrasound Society's annual conference in Columbus OH (1st place win), and presented at The Ohio State University's Denman Undergraduate Research Forum in Columbus OH (2nd place win Clinical Health Sciences).
Keywords
contrast-enhanced ultrasound, ultrasound kinetics, carpal tunnel syndrome, musculoskeletal ultrasound