School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.
School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China; Olin College of Engineering, 1000 Olin Way, Needham, 02492, US.
Med Eng Phys. 2023 Jun;116:103995. doi: 10.1016/j.medengphy.2023.103995. Epub 2023 May 16.
Elevated carpal tunnel pressure in carpal tunnel syndrome (CTS) patients is one of the major causes of nerve damage but cannot be measured non-invasively. This study proposed to use shear wave velocity (SWV) in the transverse carpal ligament (TCL) to measure the surrounding carpal tunnel pressure. The relationship between the carpal tunnel pressure and the SWV in the TCL was investigated through a subject-specific carpal tunnel finite element model reconstrued by MRI imaging. Parametric analysis was conducted to study the effect of TCL Young's modulus and carpal tunnel pressure on the TCL SWV. The SWV in TCL was found to be strongly dependent on the carpal tunnel pressure and TCL Young's modulus. The calculated SWV ranged from 8.0 m/s to 22.6 m/s under a combination of carpal tunnel pressure (0-200 mmHg) and TCL Young's modulus (1.1-11 MPa). An empirical equation was used to fit the relationship between the SWV in TCL and carpal tunnel pressure, with TCL Young's modulus as a confounding factor. The equation proposed in this study provided an approach to estimate carpal tunnel pressure by measuring the SWV in the TCL for a potential non-invasive diagnosis of CTS and may shed light on the mechanical nerve damage mechanism.
腕管综合征 (CTS) 患者的腕管内压力升高是神经损伤的主要原因之一，但无法进行无创测量。本研究提出利用横韧带 (TCL) 的剪切波速度 (SWV) 来测量周围腕管压力。通过 MRI 成像重建的特定于个体的腕管有限元模型，研究了腕管压力与 TCL SWV 之间的关系。进行了参数分析以研究 TCL 杨氏模量和腕管压力对 TCL SWV 的影响。结果发现 TCL SWV 与腕管压力和 TCL 杨氏模量密切相关。在腕管压力 (0-200mmHg) 和 TCL 杨氏模量 (1.1-11MPa) 的组合下，计算出的 SWV 范围为 8.0m/s 至 22.6m/s。使用经验公式拟合 TCL SWV 与腕管压力之间的关系，将 TCL 杨氏模量作为混杂因素。本研究提出的方程为通过测量 TCL 的 SWV 来估计腕管压力提供了一种方法，可能为 CTS 的潜在无创诊断提供了一种手段，并可能揭示机械性神经损伤的机制。
