Abstract：
BACKGROUND: Ultrasonography is used to diagnose carpal tunnel syndrome (CTS) according to various criteria. This diagnostic meta-analysis aimed to evaluate the efficacy of ultrasonography for diagnosing CTS, focusing on the cross-sectional area (CSA) of the median nerve (MN) at the inlet of the carpal tunnel and regional variations in diagnostic thresholds between Asian and non-Asian populations.
METHODS: A comprehensive literature search was conducted using PubMed, Embase, and the Cochrane Library. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Patient demographic data, diagnostic \"gold standards\", CSA cutoff values, and diagnostic results were extracted. Meta-analysis was performed to determine the sensitivity, specificity, and optimal CSA cutoff values.
RESULTS: For the 25 included studies, a combined sensitivity of 88% and specificity of 84% for CSA measurements at the carpal tunnel inlet were obtained. The Asian group had a sensitivity of 84% and specificity of 86%, while the non-Asian group had a sensitivity of 91% and specificity of 82%. The mean CSA in the Asian group was significantly lower than that in the non-Asian group (12.93 mm2 and 14.77 mm2, respectively; p = 0.042). For the Asian group, the summary receiver operating characteristic curve had an area under the curve (AUC) of 0.92 with an optimal cutoff of 10.5 mm2; for the non-Asian group, an AUC of 0.94 was obtained with a cutoff of 11.5 mm2.
CONCLUSIONS: Ultrasonography is a reliable diagnostic method for CTS, with distinct optimal cutoff values observed between Asian and non-Asian populations. Therefore, population-specific diagnostic criteria for CTS are recommended.
METHODS: A comprehensive literature search was conducted using PubMed, Embase, and the Cochrane Library. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Patient demographic data, diagnostic \"gold standards\", CSA cutoff values, and diagnostic results were extracted. Meta-analysis was performed to determine the sensitivity, specificity, and optimal CSA cutoff values.
RESULTS: For the 25 included studies, a combined sensitivity of 88% and specificity of 84% for CSA measurements at the carpal tunnel inlet were obtained. The Asian group had a sensitivity of 84% and specificity of 86%, while the non-Asian group had a sensitivity of 91% and specificity of 82%. The mean CSA in the Asian group was significantly lower than that in the non-Asian group (12.93 mm2 and 14.77 mm2, respectively; p = 0.042). For the Asian group, the summary receiver operating characteristic curve had an area under the curve (AUC) of 0.92 with an optimal cutoff of 10.5 mm2; for the non-Asian group, an AUC of 0.94 was obtained with a cutoff of 11.5 mm2.
CONCLUSIONS: Ultrasonography is a reliable diagnostic method for CTS, with distinct optimal cutoff values observed between Asian and non-Asian populations. Therefore, population-specific diagnostic criteria for CTS are recommended.
摘要：
背景：超声检查用于根据各种标准诊断腕管综合征（CTS）。这项诊断荟萃分析旨在评估超声诊断CTS的功效，重点关注腕管入口处正中神经（MN）的横截面积（CSA）以及亚洲和非亚洲人群之间诊断阈值的区域差异。
方法：使用PubMed进行了全面的文献检索，Embase,还有Cochrane图书馆.使用诊断准确性研究质量评估2（QUADAS-2）评估偏倚风险。患者人口统计数据，诊断“黄金标准”，CSA截止值，并提取诊断结果。进行Meta分析以确定灵敏度，特异性，和最佳CSA截止值。
结果：对于纳入的25项研究，对于腕管入口处的CSA测量，获得了88%的灵敏度和84%的特异性。亚洲组的敏感性为84％，特异性为86％，而非亚洲组的敏感性为91%,特异性为82%.亚洲组的平均CSA显著低于非亚洲组(分别为12.93mm2和14.77mm2;p=0.042)。对于亚洲集团来说，摘要受试者工作特征曲线的曲线下面积（AUC）为0.92，最佳截止值为10.5mm2；对于非亚洲组，获得的AUC为0.94,截断值为11.5mm2。
结论：超声检查是诊断CTS的可靠方法，在亚洲和非亚洲人群之间观察到不同的最佳临界值。因此,推荐针对人群的CTS诊断标准.
方法：使用PubMed进行了全面的文献检索，Embase,还有Cochrane图书馆.使用诊断准确性研究质量评估2（QUADAS-2）评估偏倚风险。患者人口统计数据，诊断“黄金标准”，CSA截止值，并提取诊断结果。进行Meta分析以确定灵敏度，特异性，和最佳CSA截止值。
结果：对于纳入的25项研究，对于腕管入口处的CSA测量，获得了88%的灵敏度和84%的特异性。亚洲组的敏感性为84％，特异性为86％，而非亚洲组的敏感性为91%,特异性为82%.亚洲组的平均CSA显著低于非亚洲组(分别为12.93mm2和14.77mm2;p=0.042)。对于亚洲集团来说，摘要受试者工作特征曲线的曲线下面积（AUC）为0.92，最佳截止值为10.5mm2；对于非亚洲组，获得的AUC为0.94,截断值为11.5mm2。
结论：超声检查是诊断CTS的可靠方法，在亚洲和非亚洲人群之间观察到不同的最佳临界值。因此,推荐针对人群的CTS诊断标准.
