{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:29:18Z","timestamp":1787027358050,"version":"build-2736575974"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To evaluate the diagnostic performance of high-frequency ultrasound combined with Superb Microvascular Imaging (SMI) and Shear Wave Elastography (SWE) for carpal tunnel syndrome (CTS), and to develop an individualized diagnostic approach using a body surface area (BSA)\u2013adjusted median nerve CSA at the pisiform level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This retrospective study included 47 wrists with carpal tunnel syndrome (CTS) and 94 control wrists. Median nerve cross-sectional area (CSA) was measured at four anatomical sites. Superb Microvascular Imaging (SMI) and Shear Wave Elastography (SWE) were used to assess intraneural vascularity and stiffness, respectively. A linear regression model was developed to estimate the expected CSA at the pisiform level based on body surface area (BSA), and a BSA-based Z-score was calculated accordingly. Receiver operating characteristic (ROC) analyses were performed to compare the diagnostic performance of (i) a fixed CSA cutoff at the pisiform level, (ii) the BSA-based Z-score, and (iii) a combined SMI\u2009+\u2009SWE logistic regression model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ultrasound parameters differed significantly between the CTS and control groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). The BSA-based Z-score derived from the CSA at the pisiform level yielded an AUC of 0.924 (95% CI 0.879\u20130.969) and improved specificity (83%; 95% CI 0.738\u20130.899) compared with the fixed CSA cutoff (75%; 95% CI 0.644\u20130.829). In multivariable analysis, SMI- and SWE-derived parameters remained independent predictors of CTS (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). The combined SMI\u2009+\u2009SWE logistic regression model demonstrated the best diagnostic performance (AUC 0.944; 95% CI 0.906\u20130.982), with 83% sensitivity (95% CI 0.692\u20130.924) and 90% specificity (95% CI 0.826\u20130.955).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>High-frequency ultrasound combined with Superb Microvascular Imaging (SMI) and Shear Wave Elastography (SWE) enables accurate, noninvasive evaluation of CTS. A BSA-based CSA Z-score improves specificity in CSA-based diagnosis, and integrating SMI and SWE further enhances overall diagnostic performance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1774737","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T05:27:56Z","timestamp":1771824476000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Body surface area\u2013adjusted median nerve cross-sectional area and multimodal ultrasound improve diagnosis of carpal tunnel syndrome"],"prefix":"10.3389","volume":"13","author":[{"given":"Boyi","family":"Yu","sequence":"first","affiliation":[{"name":"Ultrasound Diagnostic Center, The First Hospital Affiliated to Jilin University","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Du","sequence":"additional","affiliation":[{"name":"Ultrasound Diagnostic Center, The First Hospital Affiliated to Jilin University","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yansong","family":"Liu","sequence":"additional","affiliation":[{"name":"Ultrasound Diagnostic Center, The First Hospital Affiliated to Jilin University","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Zhang","sequence":"additional","affiliation":[{"name":"Ultrasound Diagnostic Center, The First Hospital Affiliated to Jilin University","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyu","family":"Li","sequence":"additional","affiliation":[{"name":"Ultrasound Diagnostic Center, The First Hospital Affiliated to Jilin University","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangfang","family":"Sun","sequence":"additional","affiliation":[{"name":"Ultrasound Diagnostic Center, The First Hospital Affiliated to Jilin University","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lifang","family":"Liu","sequence":"additional","affiliation":[{"name":"Ultrasound Diagnostic Center, The First Hospital Affiliated to Jilin University","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Ultrasound Diagnostic Center, The First Hospital Affiliated to Jilin University","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyue","family":"Liu","sequence":"additional","affiliation":[{"name":"Ultrasound Diagnostic Center, The First Hospital Affiliated to Jilin University","place":["Changchun, Jilin, 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