Application Of MRI In Grading Carpal Tunnel Syndrome

Objective:By studying the MRI performance of patients with carpal tunnel syndrome of different severity,the application of MRI in the grading of carpal tunnel syndrome was discussed,and the grading standard of MRI for carpal tunnel syndrome was further explored.Methods:In this paper,27patients with carpal tunnel syndrome admitted to China-Japan Union Hospital of Jilin University from 2018 January to2020 December were analyzed,including 5 male patients,aged 36-65years,with an average age of 53.4 years,22 female patients aged 33-76years,with an average age of 56.2years.From which 11 cases were unilateral,5 cases were bilateral and 40 wrists in all.According to the EMG results,the patients were divided into mild,moderate and severe groups.The cross-sectional area of median nerve,flattening rate and cross-sectional area of carpal tunnel were measured at the entrance and exit of carpal tunnel,and compared between groups.ROC curve was used to get the classification standardResult:The median nerve cross-sectional area at the carpal tunnel outlet;the median nerve flattening rate at the carpal tunnel inlet,outlet and their radio;the cross-sectional area of the carpal tunnel at the carpal tunnel outlet were not statistically significant among mild,moderate and severe groups.The median nerve cross-sectional area at the carpal tunnel inlet were 13.20±4.55 mm~2,17.65±4.64 mm~2and 20.61±5.45 mm~2in mild,moderate and severe groups,the difference between groups was statistically significant(P=0.016).The cross-sectional area of carpal tunnel at the carpal tunnel inlet was 215.60±19.71mm~2,227.24±11.43mm~2and 259.39±20.62mm~2in mild,moderate and severe groups,the difference between groups was statistically significant(P<0.001).The difference of cross-sectional area of carpal tunnel at the carpal tunnel inlet and outlet was 21.60±13.81 mm~2,31.18±13.14 mm~2and 63.50±20.06 mm~2in mild,moderate and severe groups,the difference between groups was statistically significant(P<0.001).Conclusion:MRI can provide support for the grading of carpal tunnel syndrome,The cross sectional area of the median nerve at the carpal tunnel inlet,the cross sectional area of the carpal tunnel and the difference between the cross sectional area at the carpal tunnel inlet and outlet have good consistency with the severity of carpal tunnel syndrome.We proposed to distinguish between mild and moderate carpal tunnel syndrome standardΔC-CSA value was 20mm~2,distinguish between mild and severe CTS,the standardΔC-CSA value was 48.5 mm~2.