scholarly journals Schwannoma of the median nerve mimicking carpal tunnel syndrome in a pregnant patient. Case report.

2016 ◽  
Vol 18 (4) ◽  
pp. 521
Author(s):  
Giokits-Kakavouli Giasna ◽  
Mihaela C. Micu ◽  
Romeo Micu
Keyword(s):  
Median Nerve ◽  
Carpal Tunnel ◽  
Imaging Techniques ◽  
Pregnant Patient ◽  
Nerve Lesion ◽  
Cross Section Area ◽  
Section Area ◽  
The Us ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

In patients with symptoms of a peripheral neuropathy especially during pregnancy, use of imaging techniques such as Ultrasound (US) and Magnetic Resonance Imaging (MRI) may be essential for the diagnostic accomplishment. A 30-weekspregnant diabetic female attending US evaluation due to intermittent hand pain, numbness, and weakness bilaterally. Although, the US evaluation revealed the median nerve (MN) normal size, echogenicity and echo-texture within the right carpal tunnel; the US assessment applied proximally to the carpal tunnel, revealed a hypoechoic tumor-like mass and increased MN cross section area. In transverse view, the MN was detected as an eccentric, hypoechoic structure compressed by the aforementioned mass. A presence of MN schwannoma or neurofibroma was suspected. US has been proved to be extremely useful to determine location, extent as well as the type of nerve lesion. 

scholarly journals Carpal Tunnel Syndrome Caused by A Fibrolipomatous Hamartoma of the Median Nerve

2021 ◽  
pp. 20200090
Author(s):  
Fouad Aladel ◽  
Ahmed Aldhafiri ◽  
Thabet Alghazal ◽  
Fahad Alsafran ◽  
Zainab Alrashed ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Peripheral Nerves ◽  
Benign Lesion ◽  
Invasive Procedure ◽  
Fibrolipomatous Hamartoma ◽  
Tunnel Syndrome ◽  
The Right ◽  
Patient At Risk

Fibrolipomatous hamartoma (FLH) of the nerve (also known as perineural lipoma, neural fibrolipoma, or lipomatosis of the nerve) is a well-known, rare benign lesion that can affect any peripheral nerve, resulting in significant enlargement of the involved nerve with fibrofatty infiltration. Although it is most commonly involving the median nerve, other peripheral nerves can be also involved. Being familiar with the pathognomonic characteristics on different imaging modalities and the association of this entity with macrodactyly help reach the diagnosis, avoid putting the patient at risk of an invasive procedure, and can guide management. We present to you a rare case of a FLH of the median nerve that was diagnosed on MRI of an adult female who presented with carpal tunnel syndrome (CTS) and progressive swelling of the right hand and wrist.

A Fundamentally New View of Multiple Sclerosis

2000 ◽  
Vol 2 (2) ◽  
pp. 2-8
Author(s):  
Richard Ransohoff
Keyword(s):  
Multiple Sclerosis ◽  
Imaging Techniques ◽  
Clinical State ◽  
Spinal Cord Atrophy ◽  
Axonal Pathology ◽  
Appropriate Treatment ◽  
The Us ◽  
Mri Scans ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri

Abstract The last decade has been an era of unprecedented progress in our understanding of multiple sclerosis (MS). MS is now considered a destructive process of the central nervous system, initiated by inflammatory demyelination but including prominent axonal pathology. This new knowledge has been acquired from new imaging techniques and traditional histopathologic study. New mechanisms of myelin destruction have been uncovered, and hypothetical new therapies for MS include neuroprotectants. Serial gadolinium-enhanced magnetic resonance imaging (MRI) scans reveal MS as a continuously active process. Brain and spinal cord atrophy, defined by MRI, correlate closely with clinical state. MR imaging techniques therefore are considered the standard tools for monitoring disease activity and severity. These efforts have produced improved therapy for patients with MS. Two classes of agents, interferon beta and glatiramer acetate, have been approved by the US Food and Drug Administration for use. A major challenge for clinicians is to provide early diagnosis and determine appropriate treatment. New neuroprotective and anti-inflammatory drugs are on the horizon.

scholarly journals The Leiden Convention coronary coding system: translation from the surgical to the universal view

2021 ◽  
Author(s):  
Claire J Koppel ◽  
Hubert W Vliegen ◽  
Regina Bökenkamp ◽  
A Derk Jan ten Harkel ◽  
Philippine Kiès ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Imaging System ◽  
Imaging Techniques ◽  
Cardiac Imaging Techniques ◽  
Average Score ◽  
Coding System ◽  
Left Hand ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Ct And Mri

Abstract Aims The Leiden Convention coronary coding system structures the large variety of coronary anatomical patterns; isolated and in congenital heart disease. It is widely used by surgeons but not by cardiologists as the system uses a surgeons’ cranial view. Since thoracic surgeons and cardiologists work closely together, a coronary coding system practical for both disciplines is mandatory. To this purpose, the ‘surgical’ coronary coding system was adapted to an ‘imaging’ system, extending its applicability to different cardiac imaging techniques. Methods and results The physician takes place in the non-facing sinus of the aortic valve, oriented with the back towards the pulmonary valve, looking outward from the sinus. From this position, the right-hand sinus is sinus 1, and the left-hand sinus is sinus 2. Next, a clockwise rotation is adopted starting at sinus 1 and the encountered coronary branches described. Annotation of the normal anatomical pattern is 1R-2LCx, corresponding to the ‘surgical’ coding system. The ‘imaging’ coding system was made applicable for Computed Tomography (CT), Magnetic Resonance Imaging (MRI), echocardiography, and coronary angiography, thus facilitating interdisciplinary use. To assess applicability in daily clinical practice, images from different imaging modalities were annotated by cardiologists and cardiology residents and results scored. The average score upon evaluation was 87.5%, with the highest scores for CT and MRI images (average 90%). Conclusion The imaging Leiden Convention is a coronary coding system that unifies the annotation of coronary anatomy for thoracic surgeons, cardiologists, and radiologists. Validation of the coding system shows it can be easily and reliably applied in clinical practice.

Trendelenburg position for internal jugular vein catheterization: A systematic review and meta-analysis

2021 ◽  
pp. 112972982110313
Author(s):  
Mariana Garcia-Leal ◽  
Santos Guzman-Lopez ◽  
Adrian Manuel Verdines-Perez ◽  
Humberto de Leon-Gutierrez ◽  
Bernardo Alfonso Fernandez-Rodarte ◽  
...  
Keyword(s):  
Systematic Review ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Meta Analysis ◽  
Trendelenburg Position ◽  
Cross Sectional ◽  
Cross Section Area ◽  
Section Area ◽  
Internal Jugular Vein Catheterization ◽  
The Right

To determine the effect of Trendelenburg position on the diameter or cross-section area of the internal jugular vein (IJV) a systematic review and metanalysis was performed. Studies that evaluated the cross-sectional area (CSA) and anteroposterior (AP) diameter of the right internal jugular vein (RIJV) with ultrasonography in supine and any degree of head-down tilt (Trendelenburg position) were analyzed. A total of 22 articles (613 study subjects) were included. A >5° Trendelenburg position statistically increases RIJV CSA and AP diameter. Further inclination from 10° does not statistically benefit IJV size. This position should be recommended for CVC placement, when patient conditions allow it, and US-guided cannulation is not available.

scholarly journals Automated Segmentation of Median Nerve in Dynamic Sonography Using Deep Learning: Evaluation of Model Performance

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1893
Author(s):  
Chueh-Hung Wu ◽  
Wei-Ting Syu ◽  
Meng-Ting Lin ◽  
Cheng-Liang Yeh ◽  
Mathieu Boudier-Revéret ◽  
...  
Keyword(s):  
Deep Learning ◽  
Median Nerve ◽  
Model Performance ◽  
Ultrasound Images ◽  
Learning Evaluation ◽  
Cross Section Area ◽  
Section Area ◽  
Dynamic Ultrasound ◽  
Tunnel Syndrome ◽  
And Training

There is an emerging trend to employ dynamic sonography in the diagnosis of entrapment neuropathy, which exhibits aberrant spatiotemporal characteristics of the entrapped nerve when adjacent tissues move. However, the manual tracking of the entrapped nerve in consecutive images demands tons of human labors and impedes its popularity clinically. Here we evaluated the performance of automated median nerve segmentation in dynamic sonography using a variety of deep learning models pretrained with ImageNet, including DeepLabV3+, U-Net, FPN, and Mask-R-CNN. Dynamic ultrasound images of the median nerve at across wrist level were acquired from 52 subjects diagnosed as carpal tunnel syndrome when they moved their fingers. The videos of 16 subjects exhibiting diverse appearance and that of the remaining 36 subjects were used for model test and training, respectively. The centroid, circularity, perimeter, and cross section area of the median nerve in individual frame were automatically determined from the inferred nerve. The model performance was evaluated by the score of intersection over union (IoU) between the annotated and model-predicted data. We found that both DeepLabV3+ and Mask R-CNN predicted median nerve the best with averaged IOU scores close to 0.83, which indicates the feasibility of automated median nerve segmentation in dynamic sonography using deep learning.

scholarly journals PROFIL PASIEN SINDROM TEROWONGAN KARPAL DI POLIKLINIK SARAF RSUP SANGLAH DENPASAR

2018 ◽  
Vol 35 (3) ◽  
Author(s):  
I Komang Arimbawa ◽  
Ni Komang Dewi Mahayani ◽  
I Gusti Ngurah Purna Putra ◽  
Thomas Eko Purwata
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Working Hours ◽  
Cross Sectional Study ◽  
Study Data ◽  
Cross Sectional ◽  
Neurology Clinic ◽  
Tunnel Syndrome ◽  
The Right

PROFILE OF PATIENT CARPAL TUNNEL SYNDROME IN THE NEUROLOGY CLINIC SANGLAH GENERAL HOSPITAL IN DENPASARABSTRACTIntroduction: Carpal tunnel syndrome (CTS) is the entrapment of the median nerve at the carpal tunnel.Aims: To determine the profile of patients with carpal tunnel syndrome in the Neurology Clinic Sanglah GeneralHospital in Denpasar.Methods: This is a descriptive, cross sectional study. Data was collected during a6-month period from April 2016 to September 2016.Results: Among 25 subjects, 76% were female with mean age 48+10,133 years old, housewives (40%), with working hours of more than 8 hours per day. Most subjects had symptoms on the right hand 68% in the form of tingling sensation (96%), pain (36%), numbness (48%), and hand weakness (24%). Most subject has positive Phalen test (80%), Tinnel (80%), and Flick (76%) and small number had tenar muscle atrophy (28%), impaired sensibility (32%), and decrease in muscle strength (24%). As many as 68% of subjects had distal sensoric latency of median nerve recorded on the 4th digit>3.5msec, while 72% showed ≥0.5 difference of distal sensoric latency between the median nerve and ulnar nerve, while8% showed no response.Discussion: Most patients were female, with dominant complaint was tingling, positive Phalen and Tinnel test, and68% ENMG result shown CTS.Keywords: Carpal tunnel syndrome, electroneuromyography, patient profileABSTRAKPendahuluan: Sindrom terowongan karpal (STK) adalah penjepitan N. Medianus saat melewati terowongan karpal. Tujuan: Untuk mengetahui profil pasien sindrom terowongan karpal di poliklinik saraf RSUP Sanglah, Denpasar. Metode: Penelitian potong lintang terhadap pasien dengan STK yang berobat ke poliklinik saraf RSUP Sanglah,Denpasar secara konsekutif pada bulan April-September 2016.Hasil: Dari 25 subjek, 76% adalah perempuan dengan rerata usia 48+10,133 tahun, ibu rumah tangga (40%) dengan durasi kerja lebih dari 8 jam perhari. Mayoritas keluhan terjadi pada tangan kanan (68%), berupa kesemutan (96%), nyeri (36%), rasa tebal (48%), dan kelemahan otot  tangan (24%). Sebagian besar hasil positif pada tes Phalen (80%), Tinnel (80%), dan Flick (76%), serta sebagian kecil mengalami atrofi otot tenar (28%), gangguan sensibilitas (32%), dan kelemahan otot tangan (24%). Latensi distal sensorik N. Medianus pada perekaman jari IV terutama >3,5ms (68%), perbedaan latensi distal sensorik N. Medianus dan Ulnaris ≥0,5ms (72%), dan tidak ada respons 8%.Diskusi: Sebagian besar sampel adalah perempuan, gejala yang dominan berupa kesemutan, tes Phalen dan Tinnel yang positif, serta hasil ENMG 68% menderita STK.Kata kunci: Elektroneuromiografi, profil pasien, sindrom terowongan karpal

Ruptured aneurysm of noncoronary sinus of valsalva: demonstration with magnetic resonance imaging

2008 ◽  
Vol 49 (8) ◽  
pp. 889-892 ◽  
Author(s):  
T. C. Dincer ◽  
I. Basarici ◽  
C. Calisir ◽  
A. Mete ◽  
C. Ermis ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Imaging Techniques ◽  
Sinus Of Valsalva ◽  
Resonance Imaging ◽  
Conventional Angiography ◽  
Rare Lesion ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Diagnostic Importance

There are few published reports regarding imaging findings of sinus of Valsalva aneurysms (SVA) with magnetic resonance imaging (MRI). We present an unusual form of ruptured SVA, emphasizing the diagnostic importance of MRI among a range of imaging techniques. This case report describes a case of idiopathic (thought to be congenital in origin), acutely symptomatic ruptured noncoronary SVA diagnosed by MRI and confirmed with conventional angiography and surgery. MRI accurately showed aneurysm size, location, and rupture into the right atrium and provided valuable information about this rare lesion.

STRUCTURAL CHANGES OF THE CARPAL TUNNEL, MEDIAN NERVE AND FLEXOR TENDONS IN MRI BEFORE AND AFTER ENDOSCOPIC CARPAL TUNNEL RELEASE

Hand Surgery ◽  
2014 ◽  
Vol 19 (02) ◽  
pp. 193-198 ◽  
Author(s):  
Toshimitsu Momose ◽  
Shigeharu Uchiyama ◽  
Seneki Kobayashi ◽  
Hiroyuki Nakagawa ◽  
Hiroyuki Kato
Keyword(s):  
Median Nerve ◽  
Carpal Tunnel ◽  
Structural Changes ◽  
Carpal Tunnel Release ◽  
Carpal Bone ◽  
Cross Sectional ◽  
Flexor Tendons ◽  
Endoscopic Carpal Tunnel Release ◽  
Before And After ◽  
Magnetic Resonance Imaging Mri

The purpose of this study is to investigate the structural changes of the carpal tunnel, median nerve, and flexor tendons in magnetic resonance imaging (MRI) before and after endoscopic carpal tunnel release (ECTR). We studied 36 hands undergoing ECTR. In MRI, the cross-sectional area of the carpal tunnel and the median nerve at the hamate and the pisiform levels were measured. The distance from the volar side of carpal bone to the median nerve or tendons and the volar displacement were measured. In post-operative MRI, the transverse carpal ligament could not be well delineated and the carpal tunnel was significantly enlarged both at the hamate and pisiform levels. The median nerve was enlarged at the hamate level. The median nerve and flexor tendons significantly moved to the volar side. The volar displacement of the median nerve and flexor digitorum superficialis in the long and ring fingers was greater than the other tendons.

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