腕管综合征MRI征象及其与临床特征的相关性  

Correlation between MRI signs and clinical features of carpal tunnel syndrome

作　　者：黄昀桀 陈兵[1] 杨顺[2] 向往 彭波[3] 袁放[4] HUANG Yunjie;CHEN Bing;YANG Shun;XIANG Wang;PENG Bo;YUAN Fang(Department of Radiology, Sichuan Orthopedic Hospital, Chengdu 610041, China;Wrist Department, Sichuan Orthopedic Hospital, Chengdu 610041, China;The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China;Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China)

机构地区：[1]四川省骨科医院放射科,四川成都610041 [2]四川省骨科医院手腕科,四川成都610041 [3]成都中医药大学附属医院,四川成都610075 [4]四川大学华西医院放射科,四川成都610041

出　　处：《西部医学》2021年第4期615-619,共5页Medical Journal of West China

基　　金：成都中医药大学科技发展基金项目(YYZX2018005)。

摘　　要：目的探讨腕管综合征磁共振成像(MRI)征象与临床特征的相关性。方法选取2018年1月~2019年12月四川省骨科医院手腕科门诊收治的230例腕管综合征患者及30例健康志愿者为研究对象,分别纳入腕管综合征组及对照组。收集腕管综合征患者一般资料及临床资料,对两组受试者进行电生理检查及MRI检查,比较两组差异并分析腕管综合征患者MRI参数与临床参数的相关性。结果①腕管综合征患者正中神经运动传导速度(MCV)、感觉传导速度(SCV)、复合肌肉动作电位(CMAP)、感觉神经动作电位(SNAP)显著低于对照组,末端运动潜伏期(DML)及感觉潜伏期(ML)显著长于对照组(均P<0.05)。②腕管综合征组MRI检查显示腕管结构以横断面图像最佳,T1WI、T2WI显示正中神经进入腕管部位增粗、肿胀,腕管内受压变扁,钩骨水平层面尤甚。腕管综合征患者豌豆骨正中神经截面积(CSA)、正中神经肿胀率(MNSR)、正中神经扁平率(MNFR)显著高于对照组(均P<0.05)。③豌豆骨CSA与SCV呈负相关;MNSR与静态两点辨别觉、SNAP呈正相关,与SCV呈负相关(均P<0.05)。结论MRI检查可明确腕管综合征组织结构的异常,且MRI参数与临床电生理指标存在一定相关性。Objective To explore the relationship between magnetic resonance imaging(MRI)signs and clinical features of carpal tunnel syndrome(CTS).Methods 230 patients with CTS(CTS group)who were admitted to wrist department of the hospital from January 2018 to December 2019,and 30 healthy volunteers(control group)were selected as the research subjects.General data and clinical data of patients with CTS were collected.The electrophysiological examination and MRI examination were performed in both groups.The differences between the two groups were compared.The correlation between MRI parameters and clinical parameters was analyzed.Results The median nerve motor conduction velocity(MCV),sensory conduction velocity(SCV),compound muscle action potential(CMAP)and sensory nerve action potential(SNAP)in CTS patients were significantly lower than those in control group,while distal motor latency(DML)and sensory latency(ML)were significantly longer than those in control group(P<0.05).MRI examination showed that cross-sectional images of carpal tunnel structure were the best.T1WI and T2WI showed that the carpal tunnel sites where median nerve entered were thickened and swollen.The carpal tunnels were compressed and flattened,especially at the level layer of hook bone.The median nerve cross-sectional area(CSA)of postular bone,median nerve swelling rate(MNSR)and median nerve flat rate(MNFR)in CTS patients were significantly higher than those in control group(P<0.05).CSA was negatively correlated with SCV in postular bone(P<0.05),MNSR was positively correlated with static two-point discrimination and SNAP(P<0.05),while negatively correlated with SCV(P<0.05).Conclusion MRI examination can determine organization structure abnormalities of CTS.And there is certain relationship between MRI parameters and clinical electrophysiological indexes.

关 键 词：腕管综合征 磁共振成像 电生理检查 神经传导检查 

分 类 号：R445.2[医药卫生—影像医学与核医学] R746[医药卫生—诊断学]