Pasternack Iris I, Malmivaara Antti, Tervahartiala Pekka, Forsberg Henry, Vehmas Tapio
Fin/OHTA/STAKES, P O BOX 220, FIN-00531, Helsinki, Finland.
Scand J Work Environ Health. 2003 Jun;29(3):189-96. doi: 10.5271/sjweh.721.
The objective of this systematic review was to examine the technical and diagnostic capability of magnetic resonance imaging (MRI) to identify carpal tunnel syndrome (CTS). Two independent authors retrieved and screened the existing data and extracted the clinical and validity data adhering to predefined inclusion criteria. The MRI methods and findings were analyzed by two experienced radiologists. Disagreements were solved in consensus. The MRI findings of 373 affected wrists in 13 studies were compared with asymptomatic referents or a series of patients with non-CTS wrist pain. Increased T2-signal, cross-sectional area, and flattening of the median nerve inside the carpal tunnel, as well as bowing of the flexor retinaculum, were the most frequently occurring signs in CTS. Reliable assessment of the sensitivity and specificity of certain MRI signs in respect to CTS remained difficult due to study heterogeneity. There is an obvious need for imaging studies in which validated diagnostic criteria are used.
本系统评价的目的是研究磁共振成像(MRI)识别腕管综合征(CTS)的技术和诊断能力。两位独立作者检索并筛选现有数据,按照预先设定的纳入标准提取临床和有效性数据。由两位经验丰富的放射科医生分析MRI方法和结果。分歧通过协商解决。将13项研究中373例患侧手腕的MRI结果与无症状对照者或一系列非CTS手腕疼痛患者进行比较。腕管内T2信号增强、正中神经横截面积增大、正中神经变平以及屈肌支持带弓形改变是CTS中最常见的体征。由于研究的异质性,对某些MRI体征诊断CTS的敏感性和特异性进行可靠评估仍然困难。显然需要开展使用经过验证的诊断标准的影像学研究。