Amaç: Diabetes mellituslu (DM) hastalarda karpal tünel sendromu (KTS) teşhisinde ultrasonografinin değerini ve diabetik KTS'li hastalarda radial ve ulnar arterlerin akım karakteristiklerini araştırmak amaçlanmıştır. Yöntemler: Elektrofizyolojik değerlendirme ile KTS tesbit edilen 23 el (DM-KTS), asemptomatik 47 el (DM) ve 50 sağlıklı el kontrol grubu (C), yüksek rezolüsyonlu ultrasonografiyle değerlendirildi. Median sinir kesit alanı (CSA) ve düzleşme oranı (FR), karpal tünel girişi [proksimal (p)] ve bilek kıvrımı [distal (d)] düzeylerden ölçüldü. Her iki el nötral pozisyonda iken radial ve ulnar arterler değerlendirildi.Bulgular: DM-KTS grubunda, CSA-p ve CSA-d değerleri DM ve C gruplarına göre anlamlı olarak daha büyüktü (p<0.01). FR-p, DM-KTS grubunda C grubuna göre anlamlı olarak daha büyüktü (p<0.01). ROC eğrisi analizinde, CSA-p >= 9.5 mm2 (AUC 0.84; duyarlılık 78.3% and özgüllük 88%) ve CSA-d >= 9.5 mm2 (AUC 0.78; duyarlılık 73.9% and özgüllük 84%), DM-KTS elin çok güçlü bir prediktörüdür. Doppler incelemesinde her iki radial ve ulnar arter akım volumü, pik sistolik hız, end-diyastolik hız ve rezistif indeks ölçümlerinde gruplar arası farklılık yoktu (p>0.05). Radial arter damar çapı, DM-KTS grubunda C grubuna göre anlamlı olarak daha büyüktü (p<0.05). Sonuçlar: Diabetik KTS'li hastalarda diabetli ve sağlıklı kişilere göre median sinir CSA anlamlı olarak büyüktür. Diabetik hastalarda KTS değerlendirilmesinde, ultrasonografiyle ölçülen CSA diagnostik bir araç olabilir.
Objective: This study aimed to research the value of ultrasonography in the diagnosis of carpal tunnel syndrome (CTS) in patients with diabetes mellitus (DM) and to examine the flow characteristics of the radial and ulnar arteries in diabetic patients with CTS. Methods: A total of 23 diabetic hands diagnosed with CTS from electrophysiological evaluation (DM-CTS), 47 asymptomatic diabetic hands (DM) and 50 healthy hands (C) as the control group were evaluated with high resolution ultrasonography. The median nerve was measured in the crosssectional area (CSA), flattening ratio (FR) and at the level of the carpal tunnel inlet [proximal (p)] and the wrist crease [distal (d)]. The radial and ulnar arteries were evaluated with both hands in a neutral position. Results: In the DM-CTS group, the CSA-p and CSA-d values were statistically signficantly greater compared to the DM and C groups (p<0.01). The FR-p in the DM-CTS group was statistically significantly greater than that of the C groups (p<0.01). In the ROC curve analysis, CSA-p >= 9.5 mm2 (AUC 0.84; sensitivity 78.3% and specificity 88%) and CSA-d >= 9.5 mm2 (AUC 0.78; sensitivity 73.9% and specificity 84%) were very strong predictors of the DM-CTS hand. In the Doppler examination, no difference was determined between the groups in terms of flow volume, peak systolic velocity, enddiastolic velocity and resistive index measurements of both radial and ulnar arteries (p>0.05). The radial artery diameter was determined to be statistically significantly greater in the DM-CTS group than the C group (p<0.05).Conclusion: The median nerve CSA is significantly greater in diabetic CTS patients compared to patients with diabetes only and healthy controls. In the evaluation of CTS in diabetic patients, CSA measured with ultrasonography may be a diagnostic tool.
