{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T05:34:00Z","timestamp":1762839240662,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T00:00:00Z","timestamp":1762560000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"crossref","award":["RS-2025-00532972"],"award-info":[{"award-number":["RS-2025-00532972"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Carpal Tunnel Syndrome (CTS) is the most common entrapment neuropathy. Ultrasonography is a widely used diagnostic method for CTS, and the median-to-ulnar nerve cross-sectional area ratio (MUR) is a well-known parameter. However, the ulnar nerve may be affected by various conditions of the median nerve; therefore, we considered finding further parameters. The aim of the study is to identify the correlation between the median nerve-to-ulnar artery cross-sectional area ratio (MUAR) and existing ultrasonographic parameters used as diagnostic indicators of CTS. Materials and Methods: Sixty-seven wrists from forty-two patients who were diagnosed with CTS by electrodiagnostic studies within 4 years before enrollment were retrospectively analyzed in this study. The median nerve cross-sectional area (CSA), ulnar nerve CSA, and ulnar artery CSA at full dilation were measured. In addition to well-defined CTS ultrasonographic parameters, the MUAR were calculated. All measurements were gathered at three levels. The reproducibility was evaluated through intraclass correlation coefficients (ICCs) and Bland\u2013Altman plots. Results: The MUAR at the carpal tunnel inlet showed a strong positive correlation with the MUR at the same level (\u03c1 = 0.738, p &lt; 0.05) and the median nerve wrist forearm ratio (\u03c1 = 0.541, p &lt; 0.05). In addition, the MUAR at the carpal tunnel outlet presented a strong positive correlation with MUR at the carpal tunnel inlet (\u03c1 = 0.528, p &lt; 0.05). The MUAR at 12 cm proximal to the distal wrist crease showed a strong positive correlation with the MUR at the corresponding level (\u03c1 = 0.613, p &lt; 0.05). Intra-rater and inter-rater reliability showed a high degree of agreement (ICCs &gt; 0.90). Conclusions: This study demonstrates correlations between known CTS parameters and MUAR and suggests the possibility of MUAR as a reliable CTS diagnostic tool. Further research is recommended to validate these findings.<\/jats:p>","DOI":"10.3390\/medicina61112002","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T10:35:31Z","timestamp":1762770931000},"page":"2002","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["New Ultrasonographic Parameter for Diagnosing Carpal Tunnel Syndrome: The Median Nerve-to-Ulnar Artery Cross-Sectional Area Ratio"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7722-9979","authenticated-orcid":false,"given":"Junhee","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea"},{"name":"Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Seoul 02841, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0040-8084","authenticated-orcid":false,"given":"So-Youn","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Yeouido St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8985-279X","authenticated-orcid":false,"given":"Joon Shik","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Seoul 02841, Republic of Korea"},{"name":"Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Seoul 08308, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1016\/S1474-4422(16)30231-9","article-title":"Carpal tunnel syndrome: Clinical features, diagnosis, and management","volume":"15","author":"Padua","year":"2016","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1001\/jama.282.2.153","article-title":"Prevalence of carpal tunnel syndrome in a general population","volume":"282","author":"Atroshi","year":"1999","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/S1474-4422(22)00432-X","article-title":"Carpal tunnel syndrome: Updated evidence and new questions","volume":"22","author":"Padua","year":"2023","journal-title":"Lancet Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1111\/j.1468-1331.2011.03421.x","article-title":"Contribution of ultrasound in the assessment of nerve diseases","volume":"19","author":"Padua","year":"2012","journal-title":"Eur. 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