Combination of high-frequency ultrasound and virtual touch tissue imaging and quantification improve the diagnostic efficiency for mild carpal tunnel syndrome.

BACKGROUND: Carpal tunnel syndrome (CTS) is the most common entrapment symptom in the peripheral nerves. High-frequency ultrasound (HFUS) is widely used in the diagnosis of CTS. Virtual Touch Tissue Imaging and Quantification (VTIQ), which provides more information about the hardness of organization, is used to diagnose CTS. However, the data of diagnostic value of them in various degrees of CTS are limited. Whether the combination of HFUS and VTIQ can improve the diagnostic efficiency also remains unknown. The study aimed to explore the diagnostic value of HFUS and VTIQ in various degrees of CTS and whether combination of HFUS and VTIQ could improve the diagnostic efficiency of CTS. METHODS: A collection and analysis of 133 CTS patients and 35 volunteers from January 2016 to January 2019 were performed. We compared the clinical characteristics, cross-sectional area (CSA) value and shear wave velocity SWVmean value of CTS group with volunteer group. RESULTS: The CSA value and SWVmean value of CTS cohort were significantly higher than volunteer group (10.79 ± 2.88 vs. 8.06 ± 1.39, p < 0.001, 4.36 ± 0.95 vs. 3.38 ± 1.09, p < 0.001, respectively). The area under the curve (AUC) of receiver operating characteristic (ROC) curve of CSA value and SWVmean value were 0.794 and 0.757, respectively. Hierarchical analysis of CSA value and SWVmean value showed that the AUC in the moderate and severe CTS group were higher than in mild CTS group. Furthermore, the CSA value combined with SWVmean value used to diagnose mild CTS was 0.758, which was higher than that of single CSA value or single SWVmean value. CONCLUSIONS: Both HFUS and VTIQ technology were feasible to evaluate CTS. HFUS was suitable for use in diagnosis of moderate and severe CTS. For mild CTS, combination of HFUS and VTIQ was relevant to improve the diagnostic efficiency of CTS.

[Transperineal prostate biopsy guided by dynamic intracavitary three-dimensional contrast-enhanced tomographic ultrasound imaging].

OBJECTIVE: To investigate the application value of dynamic intracavitary three-dimensional contrast-enhanced tomographic transrectal ultrasound imaging (3D-CETRUS TUI) in transperineal prostate biopsy for patients with different levels of PSA. METHODS: This prospective study included 180 patients with escalated levels of PSA (≥4 µg/L) or abnormal results of digital rectal examination. According to the level of PSA, the patients were divided into groups A (PSA ≤10 µg/L, n = 104) and B (PSA >10 µg/L, n = 76), and all underwent intracavitary 3D-CETRUS TUI followed by transperineal prostate biopsy under the guidance of two-dimensional gray-scale ultrasound, which involved a standard 12-core transperineal systematic prostate puncture by intracavitary biplane probe and then a 2-core puncture in the abnormal region displayed by 3D-CETRUS TUI. With the pathological results as the gold standard, comparisons were made between the diagnostic value of 3D-CETRUS TUI-guided biopsy and that of 12-core systematic biopsy. RESULTS: Prostate cancer was diagnosed in 69 (38.33%) of the 180 cases and in the specimens from 631 (25.03%) of the 2 520 punctures. The positive rates of prostate cancer were 37.5% (39/104) and 57.9% (44/76) in groups A and B, respectively. 3D-CETRUS TUI-guided prostate biopsy achieved a higher positive rate than 12-core systematic biopsy in both of the groups, with statistically significant difference in group A (P < 0.05), but not in B (P > 0.05). CONCLUSIONS: For patients with a PSA level ≤10 µg/L, dynamic intracavitary 3D-CETRUS TUI-guided transperineal prostate biopsy is more efficient than 12-core systematic biopsy in detecting the positive lesion, while for those with a PSA level > 10 µg/L, it effectively reduces the number of punctures.