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Carpal tunnel syndrome diagnosis by a self-normalization process and ultrasound compound imaging
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10.1118/1.4767754
/content/aapm/journal/medphys/39/12/10.1118/1.4767754
http://aip.metastore.ingenta.com/content/aapm/journal/medphys/39/12/10.1118/1.4767754

Figures

Image of FIG. 1.
FIG. 1.

Structure of the median nerve in the wrist and the midforearm.

Image of FIG. 2.
FIG. 2.

Ultrasound images of the median nerve with CTS at the wrist when the fingers had been moving for different times: (a) 0, (b) 1, and (c) 2 s. (d) CC as a function of the acquisition time. The white dashed rectangles indicate the regions of interest used to measure the CCs.

Image of FIG. 3.
FIG. 3.

Assessments of original and compound images using the SNR: (a) original image, (b) compound image, and (c) SNR estimation. The white rectangle was horizontally moved with a step of one pixel to calculate the SNR estimate across the selected depth and width of the image.

Image of FIG. 4.
FIG. 4.

Statistical parameters (mean and standard-deviation values) obtained with the original and compound images: (a) true positive (TP), (b) false negative (FN), (c) false positive (FP), and (d) shortest distance estimation.

Image of FIG. 5.
FIG. 5.

Compound images of the wrist and the midforearm for a normal subject with a BMI of 23 kg/m2 [(a) and (c), respectively] and a CTS patient with a BMI of 25 kg/m2 [(b) and (d), respectively]. The white lines delineating the median nerve contour were manually traced by an experienced physician.

Image of FIG. 6.
FIG. 6.

Compound images of the wrist and the midforearm for a normal subject with a BMI of 29 kg/m2 [(a) and (c), respectively] and a CTS patient with a BMI of 22 kg/m2 [(b) and (d), respectively]. The white lines delineating the median nerve contour were manually traced by an experienced physician.

Image of FIG. 7.
FIG. 7.

Box plots showing the CSAw (a), normalized CSA (b), FRw (c), and normalized FR estimates (d) of the compound images for the normal and CTS groups. Box plots indicate the median value (bisecting line), 25th–75th percentiles (box boundaries), and the data range (whiskers). Three asterisks indicate p < 0.001.

Image of FIG. 8.
FIG. 8.

ROC curves for using the CSAw and the normalized CSA estimates of the original and compound images to classify normal and CTS groups.

Image of FIG. 9.
FIG. 9.

Cutoff values of the CSAw estimates (a) and the normalized CSA estimates (b) for the compound images. Each hollow circle indicates a normal subject, a solid circle indicates a normal subject with BMI > 27 kg/m2, and a solid square indicates a CTS patient. The lines indicate the cutoff values for the CSAw and normalized CSA estimates of 12.15 mm2 and 1.57, respectively.

Image of FIG. 10.
FIG. 10.

Box plots showing the normalized CSA estimates of the compound images for the mild-, moderate-, and severe-CTS subgroups. Box plots indicate the median value (bisecting line), 25th–75th percentiles (box boundaries), outliers (crosses), and the data range (whiskers). Two and three asterisks indicate p < 0.01 and p < 0.001, respectively.

Tables

Generic image for table
TABLE I.

Comparison of age, weight, height, BMI, wrist circumference (measured externally at the level of the ulnar and radial styloid processes), and the results of NCS between the normal and CTS groups.

Generic image for table
TABLE II.

Individual performances assessed by the accuracy, specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), and A z value (mean ± standard error and 95% confidence interval) of each parameter in classifying normal and CTS groups.

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/content/aapm/journal/medphys/39/12/10.1118/1.4767754
2012-11-27
2014-04-16
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752b84549af89a08dbdd7fdb8b9568b5 journal.articlezxybnytfddd
Scitation: Carpal tunnel syndrome diagnosis by a self-normalization process and ultrasound compound imaging
http://aip.metastore.ingenta.com/content/aapm/journal/medphys/39/12/10.1118/1.4767754
10.1118/1.4767754
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