İdiyopatik Karpal Tünel Sendromlu Hastalarda Tedavi Öncesi ve Sonrası MRG Bulguları

Abstract

Amaç: İdiyopatik Karpal Tünel Sendromu (KTS) tanılı hastalarda splint, enjeksiyon, parafin ve cerrahi tedavinin etkinliğini Manyetik Rezonans Görüntüleme (MRG) ile değerlendirirken, farklı gözlemciler tarafından yapılan MRG ölçümleri arasındaki tutarlılığı araştırdık.

Gereç ve Yöntemler: İdiyopatik KTS tanılı 50 hastanın 50 eli Boston anketi ile değerlendirildi ve 2 farklı gözlemci tarafından MRG’de median sinir kesitsel alanı ölçüldü.

Bulgular: Tedavi öncesi ve tedaviden 3 ay sonra radiokarpal eklem düzeyi, hamat kemik düzeyine göre istatistiksel anlamlı olarak daha yüksekti (Sırasıyla p<0.001; <0.001). 1. gözlemci tarafından yapılan gerek radiokarpal eklem düzey gerek hamat kemik düzeyinde yapılan median sinir kesitsel alan ölçümünde tedavi öncesine göre tedavi sonrasında istatistiksel olarak anlamlı azalma gözlendi (Sırasıyla p<0.001; 0.002). Gözlemcilerin tedavi öncesi ve sonrası yapmış olduğu radiokarpal eklem düzey, hamat kemik düzey ölçümlerinin önemli derecede uyumlu olduğu görüldü.

Sonuç: KTS’de idyopatik KTS tanısı koyarken MRG kıymetli bir tetkiktir. Tedavinin etkinliğini değerlendirirken özellikle kanal proksimalinden yapılan median sinir kesitsel alan ölçümleri değerlidir. Farklı gözlemciler arasındaki uyumluluk ölçümlerin objektif olduğunu düşündürmektedir.

Keywords

• Karpal Tünel Sendromu,Magnetik Rezonans Görüntüleme,Sinir Kesitsel Alanı,El bileği

THE MRI FINDINGS IN PATIENTS WITH IDIOPATHIC CARPAL TUNNEL SYNDROME BEFORE AND AFTER TREATMENT

Abstract

Objective: In this study, while evaluating the effectiveness of splint, injection, paraffin and surgical treatment with Magnetic Resonance Imaging (MRI) in patients with idiopathic carpal tunnel syndrome (CTS), we investigated the consistency between MRI measurements performed by different observers.

Material and Methods: Boston questionnaires were evaluated, and the cross-sectional areas (CSA) of the median nerve were measured by two different observers, in 50 hands of 50 patients with idiopathic CTS.

Results: The CSA of the median nerve at the radiocarpal joint level of the canal were significantly larger than the values at the hamate level of the canal when values before treatment and three months after treatment were compared (p<0.001; <0.001 respectively). Measurements of the CSA of the median nerve, taken by the first observer, were found to be significantly lower in the post-treatment period at both the radiocarpal joint and hamate level, compared with the pre-treatment period (p<0.001; 0.002 respectively). Measurements of CSA of the median nerve at the radiocarpal joint and hamate level performed by the observers in the pre- and post-treatment periods, were found to be highly compatible with one another.

Conclusion: MRI is a valuable investigative technique for use with CTS patients, for the diagnosis of idiopathic CTS. When evaluating the efficacy of treatment, measurements of CSA of the median nerve are important, particularly at the proximal regions of the canal. The compatibility between the MRI measurements of the different observers, led us to consider that the measurements were objective.

Keywords

• Carpal Tunnel Syndrome,Magnetic Resonance Imaging,Cross-sectional Area,Wrist

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