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. 2020 Jan 1;33(1):54-59.
doi: 10.3344/kjp.2020.33.1.54.

The prognostic value of median nerve thickness in diagnosing carpal tunnel syndrome using magnetic resonance imaging: a pilot study

Sooho Lee  1 , Hyung Rae Cho  2 , Jun Sung Yoo  2 , Young Uk Kim  3
Affiliations

The prognostic value of median nerve thickness in diagnosing carpal tunnel syndrome using magnetic resonance imaging: a pilot study

Sooho Lee et al. Korean J Pain. .

Abstract

Background: The median nerve cross-sectional area (MNCSA) is a useful morphological parameter for the evaluation of carpal tunnel syndrome (CTS). However, there have been limited studies investigating the anatomical basis of median nerve flattening. Thus, to evaluate the connection between median nerve flattening and CTS, we carried out a measurement of the median nerve thickness (MNT).

Methods: Both MNCSA and MNT measurement tools were collected from 20 patients with CTS, and from 20 control individuals who underwent carpal tunnel magnetic resonance imaging (CTMRI). We measured the MNCSA and MNT at the level of the hook of hamate on CTMRI. The MNCSA was measured on the transverse angled sections through the whole area. The MNT was measured based on the most compressed MNT.

Results: The mean MNCSA was 9.01 ± 1.94 mm2 in the control group and 6.58 ± 1.75 mm2 in the CTS group. The mean MNT was 2.18 ± 0.39 mm in the control group and 1.43 ± 0.28 mm in the CTS group. Receiver operating characteristics curve analysis demonstrated that the optimal cut-off value for the MNCSA was 7.72 mm2, with 75.0% sensitivity, 75.0% specificity, and an area under the curve (AUC) of 0.82 (95% confidence interval [CI], 0.69-0.95). The best cut off-threshold of the MNT was 1.76 mm, with 85% sensitivity, 85% specificity, and an AUC of 0.94 (95% CI, 0.87-1.00).

Conclusions: Even though both MNCSA and MNT were significantly associated with CTS, MNT was identified as a more suitable measurement parameter.

Keywords: Anatomy; Area Under Curve; Carpal Tunnel Syndrome; Diagnosis; Hamate Bone; Magnetic Resonance Imaging; Median Nerve; ROC Curve; Wrist.

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Conflict of interest statement

CONFLICT OF INTEREST

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Axial T1-weighted carpal tunnel magnetic resonance imagings of the median nerve cross-sectional area (MNCSA) (A) and median nerve thickness (MNT) (B) at the hook of hamate level.
Fig. 2
Fig. 2
Receiver operating characteristic curve of the median nerve thickness (MNT) and median nerve cross-sectional area (MNCSA) for prediction of carpal tunnel syndrome. The most suitable cut-off point of MNT was 1.76 mm vs. 7.49 mm2 of MNCSA, with sensitivity 85% vs. 80%, specificity 85% vs. 80% and an area under the curve 0.94 vs. 0.82, respectively.
See this image and copyright information in PMC

References

    1. Chammas M, Boretto J, Burmann LM, Ramos RM, Dos Santos Neto FC, Silva JB. Carpal tunnel syndrome - part I (anatomy, physiology, etiology and diagnosis) Rev Bras Ortop. 2014;49:429–36. doi: 10.1016/j.rbo.2013.08.007. - DOI - PMC - PubMed
    1. Aroori S, Spence RA. Carpal tunnel syndrome. Ulster Med J. 2008;77:6–17. - PMC - PubMed
    1. Keith MW, Masear V, Chung K, Maupin K, Andary M, Amadio PC, et al. Diagnosis of carpal tunnel syndrome. J Am Acad Orthop Surg. 2009;17:389–96. doi: 10.5435/00124635-200906000-00007. - DOI - PMC - PubMed
    1. Ikeda M, Okada M, Toyama M, Uemura T, Takamatsu K, Nakamura H. Comparison of median nerve cross-sectional area on 3-T MRI in patients with carpal tunnel syndrome. Orthopedics. 2017;40:e77–81. doi: 10.3928/01477447-20160915-04. - DOI - PubMed
    1. Jarvik JG, Yuen E, Kliot M. Diagnosis of carpal tunnel syndrome: electrodiagnostic and MR imaging evaluation. Neuroimaging Clin N Am. 2004;14:93–102. viii. doi: 10.1016/j.nic.2004.02.002. - DOI - PubMed