PDF(Pubmed)
Abstract：
This study investigated the reliability of measuring the median nerve cross-sectional area (CSA) at the carpal tunnel inlet using a handheld ultrasound device (HUD) compared to a standard ultrasound system, focusing on intra- and inter-operator reproducibility among novice and expert operators. Employing a prospective cross-sectional design, 37 asymptomatic adults were assessed using both devices, with measurements taken by an expert with over five years of experience and a novice with less than six months. The CSA was determined using manual tracing and ellipse methods, with reproducibility evaluated through intraclass correlation coefficients (ICCs) and agreement assessed via Bland-Altman plots. Results showed a high degree of agreement between the devices, with excellent intra-operator reproducibility (ICC > 0.80) for the expert, and moderate reproducibility for the novice (ICCs ranging from 0.539 to 0.841). Inter-operator reliability was generally moderate, indicating acceptable consistency across different experience levels. The study concludes that HUDs are comparable to standard ultrasound systems for assessing median nerve CSA in asymptomatic subjects, with both devices providing reliable measurements. This supports the use of HUDs in diverse clinical environments, particularly where access to traditional ultrasound is limited. Further research with a larger sample and symptomatic patients is recommended to validate these findings.
摘要：
这项研究调查了与标准超声系统相比，使用手持式超声设备（HUD）测量腕管入口处的正中神经横截面积（CSA）的可靠性，专注于新手和专家操作员之间的操作员内和操作员间的可重复性。采用前瞻性横截面设计，使用这两种设备对37名无症状的成年人进行了评估，由具有五年以上经验的专家和不到六个月的新手进行测量。CSA是使用手动跟踪和椭圆方法确定的，通过组内相关系数（ICC）评估可重复性，并通过Bland-Altman图评估一致性。结果显示设备之间的高度一致性，对于专家而言，具有出色的操作员内部可重复性（ICC>0.80），以及新手的中等可重复性（ICC范围为0.539至0.841）。操作员间的可靠性总体上是中等的，表明不同经验水平之间可接受的一致性。该研究得出的结论是，HUDs可与标准超声系统相媲美，用于评估无症状受试者的正中神经CSA，这两种设备提供可靠的测量。这支持在不同的临床环境中使用HUDs，特别是在使用传统超声波的情况下。建议对更大样本和有症状的患者进行进一步研究以验证这些发现。
