scholarly journals Feasibility of sagittal T2 mapping of the median nerve in patients with carpal tunnel syndrome

2018 ◽  
pp. 1-6
Author(s):  
Takashi Nishii ◽  
Hideki Yoshikawa ◽  
Hiroyuki Tanaka ◽  
Hisashi Tanaka ◽  
Takashi Nishii ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
T2 Mapping ◽  
Resonance Imaging ◽  
Normal Volunteers ◽  
Tunnel Syndrome ◽  
Magnetic Resonance Imaging Mri ◽  
Flattening Ratio ◽  
Medial Nerve

Purpose: To evaluate patients with carpal tunnel syndrome (CTS) by using 3-Tesla magnetic resonance imaging (MRI) sagittal T2 mapping of the median nerve for localization of abnormal regions. Material and Methods: Nine hands of seven patients with CTS and five hands of five healthy volunteers were evaluated using sagittal T2 mapping and axial spoiled gradient-echo (SPGR) images. Three regions of interest (ROIs) at the carpal tunnel (ROI-1 to ROI-3) and one control ROI distal to the carpal tunnel (ROIC) were defined on the median nerve and T2-ratios at ROI-1 to ROI-3 relative to ROI-C were calculated. The flattening ratio (F-ratio; width/height of the median nerve) was also calculated from the axial SPGR images. Results: On sagittal T2 mapping, the medial nerve of normal volunteers showed constant T2 values at all ROIs. In the patients with CTS, there was large variation in T2 among the ROIs and the region of highest T2 value varied among the patients. T2-ratios at ROI-2 and -3 and the F-ratios along all carpal tunnel levels were significantly higher in the patients with CTS than in the normal volunteers. A significant correlation was found between terminal latency and T2-ratio at ROI-2 but not between terminal latency and F-ratio. Conclusion: Sagittal T2 mapping was feasible for the localization of abnormal T2 regions of the median nerve in patients with CTS.

scholarly journals Carpal tunnel syndrome caused by cysticercosis

2010 ◽  
Vol 43 (02) ◽  
pp. 210-212
Author(s):  
S. R. Sharma ◽  
Nalini Sharma ◽  
M. E. Yeolekar
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction Studies ◽  
Resonance Imaging ◽  
Inflammatory Mass ◽  
Tunnel Syndrome ◽  
Median Neuropathy

ABSTRACTWe present a case of carpal tunnel syndrome (CTS) due to compression of the median nerve within the carpal tunnel, caused by cysticercosis. Nerve conduction studies revealed severe CTS. Magnetic resonance imaging suggested an inflammatory mass compressing the median nerve in carpal tunnel. The histological diagnosis was consistent with cysticercosis. The case resolved with conservative treatment. Such solitary presentation of entrapment median neuropathy as CTS caused by cysticercosis is extremely rare. To our knowledge, this is the only case of its kind reported in literature till date.

scholarly journals The Value of Morphologic Study (MRI) of the Median Nerve in Stadialization and Treatment of the Carpal Tunnel Syndrome

2021 ◽  
Vol 28 (4) ◽  
pp. 407-411
Author(s):  
Florin Gabriel PANCULESCU ◽  
◽  
Raluca STEFANESCU ◽  
Ion BORDEIANU ◽  
Iulian Catalin BRATU ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Morphological Changes ◽  
Study Group ◽  
Advanced Stage ◽  
Resonance Imaging ◽  
Morphologic Study ◽  
Therapeutic Algorithm ◽  
Tunnel Syndrome

Carpal tunnel syndrome is a sensitive neuropathy of the upper limb caused by chronic compression of the median nerve. The presented study focused on highlighting the value of morphological changes of the median nerve - shown by MRI in the management of carpal tunnel syndrome. The study group included 23 patients, adults, treated in the Plastic Surgery Clinic of the County Emergency Clinical Hospital in Constanta - prospective study. Magnetic resonance imaging allowed accurate measurement of the median nerve diameter and showed significant decreases in most cases, which suggested an advanced stage of the disease - morphological changes being corroborated with clinical ones. This imagistic investigation opens a new way in establishing the surgical indication, which is required in case of reduction of the nerve diameter by at least 1.5mm at the site of compression. The criterion of diameter decrease can be a benchmark in order to establish a therapeutic algorithm in carpal tunnel syndrome.

Median Nerve Injury in Ultrasound-Guided Hydrodissection and Corticosteroid Injections for Carpal Tunnel Syndrome

2020 ◽  
Author(s):  
Yi-Chih Hsu ◽  
Fu-Chi Yang ◽  
Hsian-He Hsu ◽  
Guo-Shu Huang
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Clinical Data ◽  
Vascular Injury ◽  
Carpal Tunnel ◽  
Corticosteroid Injection ◽  
Tunnel Syndrome ◽  
Flattening Ratio ◽  
Median Nerve Injury ◽  
Corticosteroid Injections

Abstract Purpose Permanent nerve damage after corticosteroid injection has been suggested when symptoms of median nerve injury (MNI) are irreversible. We assess the outcomes of MNI and their association with ultrasonography (US)-guided hydrodissection and the following corticosteroid injection for symptomatic carpal tunnel syndrome (CTS). Methods US-guided hydrodissection and the following corticosteroid injections were administered to 126 CTS patients. Occurrence of MNI, clinical data, and post-hydrodissection findings were evaluated. Post-hydrodissection findings included vascular injury during hydrodissection, altered echogenicity, reduced flattening ratio, and increased cross-sectional area of the MN at the inlet of the carpal tunnel (MN-CSA-Inlet) on ultrasonography after hydrodissection. The relevance of MNI with respect to these clinical data and findings was determined. The outcome was rated using Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) scores. Results Nine patients suffered MNI (incidence, 7.1 %) but improved significantly at follow-up. Clinical data and vascular injury during hydrodissection, altered echogenicity, and reduced flattening ratio after hydrodissection were unrelated to prolonged transient MNI (p > 0.05). MNI was significantly associated with increased CSA (p = 0.005). A CSA increase > 2 mm2 after hydrodissection yielded the greatest performance (0.979) for MNI in the receiver operating characteristic analysis. Decreases in BCTQ scores after injection did not differ significantly between groups with and without MNI (p > 0.05). Conclusion MNI during hydrodissection may be reversible. MNI is indicated by an increase in MN-CSA-inlet immediately after hydrodissection.

T2 mapping of the median nerve in patients with carpal tunnel syndrome and healthy volunteers

2021 ◽  
Vol 63 (5) ◽  
pp. 774-777
Author(s):  
Atsushi Maeda ◽  
Taku Suzuki ◽  
Katsuhiko Hayakawa ◽  
Takuya Funahashi ◽  
Takashi Kuroiwa ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Healthy Volunteers ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
T2 Mapping ◽  
Tunnel Syndrome

scholarly journals OBLIGATORY ALTERATIONS IN THE MORPHOLOGY OF MEDIAN NERVE: A SONOGRAPHIC STUDY IN ASYMPTOMATIC INDIVIDUALS

2018 ◽  
Vol 26 (2) ◽  
Author(s):  
Vandana Lakra ◽  
Garima Sehgal ◽  
Jyoti Chopra ◽  
Anita Rani ◽  
Kaweri Dande
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Linear Probe ◽  
Tunnel Syndrome ◽  
Asymptomatic Individuals ◽  
Flattening Ratio

Introduction: Median nerve is formed in axilla by contributions from medial and lateral cords of brachial plexus. It descends in the arm, forearm and then through carpal tunnel in close conjunction with flexor tendons of forearm. Carpal tunnel syndrome (CTS) is a common entrapment neuropathy. Median nerve cross sectional area (CSA) and ratio of nerve major axis to minor axis (flattening ratio) serve as potential diagnostic criteria for carpal tunnel syndrome. Median nerve cross sectional area and flattening ratio (FR) can be assessed by ultrasonography (US). Aim of the study was to assess median nerve by US and tabulate mean values for CSA and FR in asymptomatic population. This would serve to limit the cut-off values that differentiate asymptomatic nerves from neuropathic nerves. Material & Methods: Study was conducted in the Department of Anatomy, KGMU, Lucknow. Fifty randomly selected asymptomatic volunteers (undergraduate students: 30 males, 20 females) participated in the study. Sonography was performed to evaluate certain morphological dimensions of median nerve. Height, weight and wrist circumference of participants were also noted. Ultrasonography was performed using high frequency linear probe and observations were made at two pre-determined sites. Observations were recorded, tabulated and analyzed. Results: Median nerve was easily observable at both sites. It was round in shape in forearm (Fo), and flattened as it reached the carpal tunnel (Ct). Among all 50 study subjects, at both sites, flattening was more on right side (FRFoRt-1.71; FRCtRt-3.08) than on left side (FRFoLt-1.66; FRCtLt-2.78). In right forearm, nerve was flatter in females (FRFoRt-1.77) as compared to males (FRFoRt-1.68). In left forearm, median nerve was slightly rounder in females (FRFoLt-1.65) as compared to males (FRFoLt-1.67). At the distal wrist crease on right side, increased flattening was observed in females (FRCtRt-3.30) as compared to males (FRCtRt-2.94), whereas on left side, at same site flattening was more in females (males FRCtLt-2.74; females FRCtLt-2.83). Conclusion: Altered FR has both diagnostic as well as prognostic values in carpal tunnel syndrome. The database generated from the study will help in facilitating comparisons between normal, asymptomatic and pathological, asymptomatic individuals.

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