Campagna Raphaël, Pessis Eric, Feydy Antoine, Guerini Henri, Le Viet Dominique, Corlobé Patrick, Drapé Jean-Luc
Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Service de Radiologie B, Hôpital Cochin, 27 rue du Faubourg Saint Jacques, 75679 Paris Cedex 14, France.
AJR Am J Roentgenol. 2009 Sep;193(3):644-50. doi: 10.2214/AJR.08.1433.
The purpose of this study was to retrospectively determine the accuracy of MRI in identification of the morphologic features of median nerve dysfunction after surgical release of the median nerve for carpal tunnel syndrome.
Two blinded readers independently evaluated axial 1.5-T MR images for retinacular regrowth, morphologic characteristics of the median nerve, and presence of mass effect, fibrosis, and carpal tunnel decompression. All 47 patients (11 men, 36 women; mean age, 55 years; range, 27-81 years) had undergone open surgical release of the median nerve for carpal tunnel syndrome. Thirty-five patients had electromyographic evidence of recurrent carpal tunnel syndrome. The other 12 patients did not have electrophysiologic evidence of recurrent carpal tunnel syndrome and were the control group.
A statistically significant difference between the recurrent carpal tunnel syndrome and control groups was found for fibrosis (p = 0.009), nerve enhancement (p = 0.04), and median nerve width (p = 0.008) and ratio (p = 0.01) at the pisiform level.
MRI may be used in association with electromyography for accurate postoperative evaluation of the carpal tunnel.
本研究的目的是回顾性地确定磁共振成像（MRI）在识别腕管综合征正中神经松解术后正中神经功能障碍形态学特征方面的准确性。
两名盲法阅片者独立评估1.5-T轴位MR图像，观察支持带再生长情况、正中神经形态特征以及是否存在占位效应、纤维化和腕管减压情况。所有47例患者（11例男性，36例女性；平均年龄55岁；范围27 - 81岁）均因腕管综合征接受了正中神经开放性松解术。35例患者有复发性腕管综合征的肌电图证据。另外12例患者没有复发性腕管综合征的电生理证据，作为对照组。
在豌豆骨水平，复发性腕管综合征组与对照组在纤维化（p = 0.009）、神经强化（p = 0.04）、正中神经宽度（p = 0.008）和比率（p = 0.01）方面存在统计学显著差异。
MRI可与肌电图联合用于腕管术后的准确评估。
