Objective: Ultrasound (US) examination has unique advantages in diagnosing carpal tunnel syndrome (CTS) while identifying the median nerve (MN) and diagnosing CTS depends heavily on the expertise of examiners. To alleviate this problem, we aimed to develop a one-stop automated CTS diagnosis system (OSA-CTSD) and evaluate its effectiveness as a computer-aided diagnostic tool. Methods: We combined real-time MN delineation, accurate biometric measurements, and explainable CTS diagnosis into a unified framework, called OSA-CTSD. We collected a total of 32,301 static images from US videos of 90 normal wrists and 40 CTS wrists for evaluation using a simplified scanning protocol. Results: The proposed model showed better segmentation and measurement performance than competing methods, reporting that HD95 score of 7.21px, ASSD score of 2.64px, Dice score of 85.78%, and IoU score of 76.00%, respectively. In the reader study, it demonstrated comparable performance with the average performance of the experienced in classifying the CTS, while outperformed that of the inexperienced radiologists in terms of classification metrics (e.g., accuracy score of 3.59% higher and F1 score of 5.85% higher). Conclusion: The OSA-CTSD demonstrated promising diagnostic performance with the advantages of real-time, automation, and clinical interpretability. The application of such a tool can not only reduce reliance on the expertise of examiners, but also can help to promote the future standardization of the CTS diagnosis process, benefiting both patients and radiologists.

翻译：目的：超声检查在诊断腕管综合征方面具有独特优势，但正中神经的识别和腕管综合征的诊断高度依赖检查者的专业知识。为解决这一问题，我们旨在开发一种一站式腕管综合征自动诊断系统（OSA-CTSD），并评估其作为计算机辅助诊断工具的有效性。方法：我们将实时正中神经勾画、精确生物特征测量和可解释性腕管综合征诊断整合为一个统一框架，称为OSA-CTSD。我们采用简化扫描方案，从90个正常手腕和40个腕管综合征手腕的超声视频中收集了总计32,301张静态图像进行评估。结果：所提出的模型在分割和测量性能上优于对比方法，报告显示HD95得分为7.21像素，ASSD得分为2.64像素，Dice得分为85.78%，IoU得分为76.00%。在阅读者研究中，该模型在腕管综合征分类方面表现出与经验丰富医师平均水平相当的性能，同时在分类指标上优于经验不足的放射科医师（例如，准确率高出3.59%，F1分数高出5.85%）。结论：OSA-CTSD展现了良好的诊断性能，具有实时、自动化和临床可解释性的优势。该工具的应用不仅能减少对检查者专业知识的依赖，还有助于推动腕管综合征诊断流程的标准化，惠及患者和放射科医师。