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- Title
High-resolution MRI predicts steroid injection response in carpal tunnel syndrome patients.
- Authors
Aoki, Takatoshi; Oshige, Takahisa; Matsuyama, Atsushi; Oki, Hodaka; Kinoshita, Shunsuke; Yamashita, Yoshiko; Takahashi, Hiroyuki; Hayashida, Yoshiko; Sakai, Akinori; Hisaoka, Masanori; Korogi, Yukunori
- Abstract
Objectives: To correlate median nerve T2 signal and shape at the carpal tunnel with steroid injection (SI) response in carpal tunnel syndrome (CTS) patients. Methods: One hundred and sixty-three CTS wrists of 92 consecutive patients who were scheduled to undergo SI were prospectively evaluated with 3-T magnetic resonance imaging (MRI) and a nerve conduction study. All patients underwent axial high-resolution T2-weighted MRI (in-plane resolution of 0.25 × 0.25 mm). The CTS wrists were classified into three groups according to the nerve T2 signal and the flattening ratio at the hook of hamate level: group 1, high and oval; group 2, high and flat; group 3, low and flat. Clinical response to SI was evaluated at 6 months after injection. Results: One hundred and thirteen of the 163 wrists (69.3 %) responded well to SI. The percentage of improvement was 81.7 % (49/60) in group 1, 69.9 % (51/73) in group 2, and 43.3 % (13/30) in group 3 ( P < 0.01). On stepwise logistic regression analysis high-resolution MRI was the only significant independent factor for SI response in CTS patients ( P < 0.01). Conclusions: High-resolution MRI correlates well with SI response in CTS patients and seems useful for predicting SI response. Key Points: • MRI may help determine appropriate care in carpal tunnel syndrome. • MRI helps in therapeutic decision-making whenever steroid injection is considered. • T2 signal decrease of the median nerve correlates with poor outcome. • T2 signal decrease of median nerve may reflect fibrosis and amyloid deposition.
- Subjects
MEDIAN nerve; PHYSIOLOGICAL effects of steroids; CARPAL tunnel syndrome; MAGNETIC resonance imaging; NEURAL conduction; PATIENTS
- Publication
European Radiology, 2014, Vol 24, Issue 3, p559
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-013-3064-y