İdiyopatik Karpal Tünel Sendromlu Hastalarda Tedavi Öncesi ve Sonrası MRG Bulguları

Yıl 2019, Cilt: 21 Sayı: 3, 302 - 312, 31.12.2019

Şahika Burcu Karaca Rula Şahin Leman Günbey Karabekmez Tevfik Yetiş Nihal Duran

https://doi.org/10.24938/kutfd.545513

Öz

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.

Anahtar Kelimeler

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

Öz

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.

Anahtar Kelimeler

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

Kaynakça

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