SDMS CME Credit – Assessing the Potential for Error in Investigating Intraneural Vascularity: A Need for a Standardized Imaging Protocol

SDMS members can earn SDMS CME credit by successfully completing the complimentary online CME test in the SDMS Learning Center at learn.sdms.org. Non-members may access the online CME test for a fee. Note: questions may appear in random order online.

Authors: Buwen Yao, PhD, MBBS, Kevin D. Evans, PhD, RT (R) (M) (BD), RDMS, RVS, FSDMS, FAIUM, and Shawn C. Roll, PhD, OTR/L, RMSKS, FAOTA, FAIUM

Category: Musculoskeletal [MSK]

Credit: 1.25 SDMS CME Credit

Objectives: After studying the article, you should be able to:

• Discuss the importance of median nerve doppler in relation to carpal tunnel syndrome.

• Describe the anatomic landmarks for imaging the median nerve.

• Interpret confirmed prevalence in the proximal, mid, and distal median nerve.

1. Which segment of the carpal tunnel is located superficial to1 the lunate and capitate bones?

2. B. Mid CT

3. C. Distal CT

4. D. Intermediate CT

The vascularity assessment began with a preset pulse repetition frequency at 0.6 kHz and gain set at ____ dB to serve as the baseline for all examinations.

A. 5.5

B. 6.4

C. 8.5

D. 7.5

One requirement for intraneural blood flow validity, based on video evidence, was which of the following?

A. The signal had at least three pulsatile cycles

B. The signal was a flash artifact

C. The signal was located outside the hyperechoic border

D. The signal had at least five pulsatile cycles

The assumed prevalence of intraneural blood flow is calculated by dividing the assumed presence of blood flow by _______.

A. Evidenced cases

B. All available cases

C. Missing cases

D. Mixed cases

How many pulsatile blood flow signals should be saved on a video clip?

A. 2

B. 3

C. 5

D. 4

Which nerve was imaged during the carpal tunnel study?

A. Radial

B. Ulnar

C. Axillary

D. Median

For all examinations performed, the baseline preset in kHz was what for pulse repetition frequency?

A. 1.5

B. 1.7

C. 0.6

D. 2.0

If blood flow is not identified, the sonographer should _________.

A. Take a still image with a flat waveform

B. Take an image with spectral doppler of another vessel

C. Take no images of this area

D. Increase the doppler gain to demonstrate the noise level

Previous studies have found that CT syndrome patients have ______ intraneural blood flow versus healthy people.

A. Equal

B. Less

C. More

D. Static

Confirmed prevalence describes __________.

A. The presence of high velocity waveforms

B. Noise level

C. Missing cases

D. The presence or absence of blood flow