Department of Radiology, Urmia University of Medical Sciences, Urmia, West-Azerbaijan, Iran.
AJR Am J Roentgenol. 2012 Feb;198(2):W181-4. doi: 10.2214/AJR.11.7012.
Carpal tunnel syndrome (CTS) represents one of the most prevalent peripheral entrapment mononeuropathies. The purpose of our study was to assess the potential correlation between intraneural hypervascularization, flexor retinaculum bowing, and median nerve cross-sectional area and the severity of CTS in cases confirmed by nerve conduction study.
Sixty consecutive patients with classic or probable symptoms of CTS were enrolled in the study. A control group consisting of 27 healthy volunteers who were never diagnosed with CTS or had any symptoms of CTS was recruited among institution employees. All symptomatic patients were initially examined by a hand surgeon and subsequently referred for sonographic and electrophysiologic examinations.
A total of 90 wrists (in 60 patients) were included in the study. Twenty-eight (31.1%) had mild CTS, 33 had moderate disease, and 29 had severe disease. We detected significant correlation between median nerve hypervascularization and the severity of CTS (p = 0.01, logistic regression) for moderate CTS and (p = 0.04) for severe disease. We also detected a significant correlation in flexor retinaculum bowing and median nerve cross-sectional area with increase in the severity of CTS (p < 0.001 and < 0.008; chi-square test and analysis of variance, respectively).
Our study suggests that the severity of CTS strongly correlates with color Doppler sonography findings, and this technique may represent a reliable complementary tool in CTS examination.
腕管综合征(CTS)是最常见的周围神经嵌压性单神经病之一。本研究旨在评估神经传导研究证实的 CTS 患者正中神经内血管增生、屈肌支持带弯曲和正中神经横截面积与 CTS 严重程度之间的潜在相关性。
连续纳入 60 例有典型或可能 CTS 症状的患者。在机构员工中招募了一个对照组,由 27 名从未被诊断为 CTS 或有 CTS 症状的健康志愿者组成。所有有症状的患者首先由手外科医生检查,然后进行超声和电生理检查。
共有 90 个手腕(60 例患者)纳入研究。28 例(31.1%)为轻度 CTS,33 例为中度疾病,29 例为重度疾病。我们发现,在中度 CTS(p=0.01,逻辑回归)和重度疾病(p=0.04)中,正中神经血管增生与 CTS 严重程度之间存在显著相关性。我们还发现,屈肌支持带弯曲和正中神经横截面积与 CTS 严重程度的增加之间存在显著相关性(p<0.001 和<0.008;卡方检验和方差分析)。
我们的研究表明,CTS 的严重程度与彩色多普勒超声检查结果密切相关,该技术可能是 CTS 检查的一种可靠的补充工具。