Ikeda Mikinori, Okada Mitsuhiro, Toyama Masahiko, Uemura Takuya, Takamatsu Kiyohito, Nakamura Hiroaki
Orthopedics. 2017 Jan 1;40(1):e77-e81. doi: 10.3928/01477447-20160915-04. Epub 2016 Sep 21.
This study correlated morphologic abnormalities of idiopathic carpal tunnel syndrome (CTS) with the severity of CTS using 3-T magnetic resonance imaging (MRI). The relationship of the severity of CTS and the cross-sectional area of the median nerve (CSA) was assessed at several levels. Seventy wrists of 35 patients (27 women and 8 men) with unilateral idiopathic CTS underwent nerve conduction study and 3-T MRI of the wrist. The CSA at 4 levels (distal radioulnar joint, body of scaphoid, tubercule of scaphoid, and hook of hamate) and the thickness of the transverse carpal ligament at 3 levels in both affected and unaffected hands were measured using 3-T MRI and correlated with the severity of CTS assessed with distal motor latency. The CSA in the affected hand at the scaphoid body level was significantly higher than in the unaffected hand. The CSA at the scaphoid body level was positively correlated with distal motor latency in the affected hand. The CSA in the affected hand at the scaphoid tubercule level was significantly lower than in the unaffected hand. The CSA had a negative correlation with distal motor latency at the scaphoid tubercule level. The CSA at the distal radioulnar joint and the hamate hook was not significantly different between the affected hand and the unaffected hand. The CSA at the distal radioulnar joint level and hook level were not correlated significantly with distal motor latency in the affected hand. The mean CSA of the affected hand at the scaphoid body level was highest in 4 levels. [Orthopedics. 2017; 40(1):e77-e81.].
本研究使用3T磁共振成像（MRI）将特发性腕管综合征（CTS）的形态学异常与CTS的严重程度相关联。在几个层面评估了CTS严重程度与正中神经横截面积（CSA）之间的关系。对35例单侧特发性CTS患者（27例女性和8例男性）的70只手腕进行了神经传导研究和手腕的3T MRI检查。使用3T MRI测量患侧和未患侧手在4个层面（远侧桡尺关节、舟骨体、舟骨结节和钩骨钩）的CSA以及在3个层面的腕横韧带厚度，并将其与通过远侧运动潜伏期评估的CTS严重程度相关联。患侧手舟骨体水平的CSA显著高于未患侧手。患侧手舟骨体水平的CSA与远侧运动潜伏期呈正相关。患侧手舟骨结节水平的CSA显著低于未患侧手。患侧手舟骨结节水平的CSA与远侧运动潜伏期呈负相关。患侧手与未患侧手在远侧桡尺关节和钩骨钩处的CSA无显著差异。患侧手远侧桡尺关节水平和钩骨钩水平的CSA与远侧运动潜伏期无显著相关性。患侧手舟骨体水平的平均CSA在4个层面中最高。[《骨科学》。2017年；40（1）：e77 - e81。]
