Magnetic resonance neurography of median neuropathies proximal to the carpal tunnel

Thawait, Gaurav K.; Subhawong, Ty K.; Thawait, Shrey K.; Andreisek, Gustav; Belzberg, Alan J.; Eng, John; Carrino, John A.; Chhabra, Avneesh

doi:10.1007/s00256-012-1380-y

Cited by 11 publications

(8 citation statements)

References 36 publications

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“…Median nerve CSA is a key feature in the US or MRI diagnosis of CTS . This study compared median nerve CSA measurements made on US and MRI with those made on anatomical sectioning.…”

Section: Discussionmentioning

confidence: 99%

“…The magnetic resonance imaging (MRI) criteria to diagnose CTS are not as well established as those of US . The usual MRI methods used are median nerve CSA, palmar bowing as well as T2 mapping, diffusion tensor imaging, or MR neurography . As there is no magnification effect or other structural distortion, one would expect US and MRI measurements of median nerve CSA to be comparable.…”

Section: Introductionmentioning

confidence: 99%

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Cross‐sectional area of the median nerve at the wrist: Comparison of sonographic, MRI, and cadaveric measurements

Lee

Griffith

et al. 2018

J of Clinical Ultrasound

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Background: This study compares median nerve cross-sectional area (CSA) measurements at the wrist obtained with ultrasound (US) and magnetic resonance imaging (MRI) using cadaveric measurements as the gold standard.Methods: Median nerve CSA was measured using US and MRI in 9 cadaveric wrists obtained from 5 subjects at 5 locations: distal forearm, proximal to tunnel inlet, at tunnel inlet, at tunnel outlet, and distal to tunnel outlet and then on identical cadaveric transverse sections obtained with a bandsaw. All US, MRI, and cadaveric measurements were repeated to determine reliability. Median nerves of 10 patients with clinical carpal tunnel syndrome (CTS) were measured with US and MRI using an identical method US.Results: Median nerve CSA MRI measurements correlated better (Pearson correlation: 0.80-0.95, P < .05) with cadaveric measurements than with US measurements (Pearson correlation: 0.61-0.79, P < .05). Median nerve CSA US measurements (8.6-12.5 mm 2 , P < .05) were smaller at all levels than MRI (11.3-14.7 mm 2 ) or cadaveric (11.0-14.9 mm 2 ) measurements while MRI and cadaver measurements were similar at all levels. Median nerve CSA MRI measurements in CTS patients were larger than US measurements at all levels. Conclusion: Median nerve CSA measurements by MRI are larger than US measurements and correlated better with cadaveric measurements. Median nerve CSA criteria used for diagnosing CTS on US are not likely to be applicable to MRI. K E Y W O R D S cross sectional, measurement, median nerve, MRI, ultrasound

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“…Median nerve CSA is a key feature in the US or MRI diagnosis of CTS . This study compared median nerve CSA measurements made on US and MRI with those made on anatomical sectioning.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cross‐sectional area of the median nerve at the wrist: Comparison of sonographic, MRI, and cadaveric measurements

Lee

Griffith

et al. 2018

J of Clinical Ultrasound

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“…On MRN, a normal median nerve appears hypointense on a T1-weighted (T1W) image and isointense to minimally hyperintense on a T2-weighted (T2W) image along the course of the arm. 16 Deviations from the norm may be interpreted as signs of an underlying condition. 17 18 19 For example, findings of chronic nerve entrapment on MRN include nerve swelling proximally and sometimes distally with an abrupt transition to a flattened contour at the entrapment site.…”

Section: Upper Extremity Nerve Entrapmentsmentioning

confidence: 99%

Magnetic Resonance Neurography for Evaluation of Peripheral Nerves

Cox

Mikeska

2021

J Brachial Plex Peripher Nerve Inj

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Peripheral nerve injuries (PNIs) continue to present both diagnostic and treatment challenges. While nerve transections are typically a straightforward diagnosis, other types of PNIs, such as chronic or traumatic nerve compression, may be more difficult to evaluate due to their varied presentation and limitations of current diagnostic tools. As a result, diagnosis may be delayed, and these patients may go on to develop progressive symptoms, impeding normal activity. In the past, PNIs were diagnosed by history and clinical examination alone or techniques that raised concerns regarding accuracy, invasiveness, or operator dependency. Magnetic resonance neurography (MRN) has been increasingly utilized in clinical settings due to its ability to visualize complex nerve structures along their entire pathway and distinguish nerves from surrounding vasculature and tissue in a noninvasive manner. In this review, we discuss the clinical applications of MRN in the diagnosis, as well as pre- and postsurgical assessments of patients with peripheral neuropathies.

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“…Carpal tunnel syndrome is extensively described in the literature and was, therefore, not included in this review. [17][18][19] Diagnoses of musculoskeletal soft-tissue tumours were also excluded. No language restrictions were applied.…”

Section: Study Selection Criteriamentioning

confidence: 99%

Diagnostic accuracy of history taking, physical examination and imaging for non-chronic finger, hand and wrist ligament and tendon injuries: a systematic review update

et al. 2020

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ObjectiveThe diagnostic work-up for ligament and tendon injuries of the finger, hand and wrist consists of history taking, physical examination and imaging if needed, but the supporting evidence is limited. The main purpose of this study was to systematically update the literature for studies on the diagnostic accuracy of tests for detecting non-chronic ligament and tendon injuries of the finger, hand and wrist.MethodsMedline, Embase, Cochrane Library, Web of Science, Google Scholar ProQuest and Cinahl were searched from 2000 up to 6 February 2019 for identifying studies. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 checklist, and sensitivity (Se), specificity (Sp), accuracy, positive predictive value (PPV) and negative predictive value (NPV) were extracted.ResultsNone of the studies involved history taking. Physical examination, for diagnosing lesions of the triangular fibrocartilage complex (TFCC), showed Se, Sp, accuracy, PPV and NPV ranging from 58% to 90%, 20% to 69%, 56% to 73%, 53% to 71% and 55% to 65%, respectively. Physical examination in hand and finger injuries the Se, Sp, accuracy, PPV and NPV ranged from 88% to 99%, 75% to 100%, 34% to 88%, 91% to 100% and 75% to 95%, respectively. The accuracy of MRI with high-resolution (3 T) techniques for TFCC and interosseous ligaments of the proximal carpal row ranged from 89% to 91% and 75% to 100%, respectively. The accuracy of MRI with low-resolution (1.5 T) techniques for TFCC and interosseous ligaments of the proximal carpal row ranged from 81% to 100% and 67% to 95%, respectively.ConclusionsThere is limited evidence on the diagnostic accuracy of history taking and physical examination for non-chronic finger, hand and wrist ligament and tendon injuries. Although some imaging modalities seemed to be acceptable for the diagnosis of ligament and tendon injuries in the wrist in patients presenting to secondary care, there is no evidence-based advise possible for the diagnosis of non-chronic finger, hand or wrist ligament and tendon injuries in primary care.

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Magnetic resonance neurography of median neuropathies proximal to the carpal tunnel

Cited by 11 publications

References 36 publications

Cross‐sectional area of the median nerve at the wrist: Comparison of sonographic, MRI, and cadaveric measurements

Cross‐sectional area of the median nerve at the wrist: Comparison of sonographic, MRI, and cadaveric measurements

Magnetic Resonance Neurography for Evaluation of Peripheral Nerves

Diagnostic accuracy of history taking, physical examination and imaging for non-chronic finger, hand and wrist ligament and tendon injuries: a systematic review update

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