Visualization of the morphological changes in the median nerve after carpal tunnel release using three-dimensional magnetic resonance imaging

Takuya Funahasi, Taku Suzuki, Katsuhiko Hayakawa, Takashi Nakane, Atsushi Maeda, Takashi Kuroiwa, Yusuke Kawano, Takuji Iwamoto, Nobuyuki Fujita

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: This study aimed to compare the pre- and postoperative morphology of the median nerve using three-dimensional (3-D) MRI in patients with carpal tunnel syndrome (CTS). Methods: We assessed 31 patients with CTS who underwent open carpal tunnel release and T2*-weighted MRI of the wrist preoperatively and at 6 months postoperatively. The median nerve morphology was evaluated on the basis of the cross-sectional areas (CSAs) and cross-sectional volumes (CSVs). The association between these MRI findings and nerve conduction studies was also evaluated. Results: The mean preoperative CSA and CSV values at the proximal carpal tunnel level significantly decreased from 22.2 mm2 and 24.4 mm3 to 16.5 mm2 and 18.1 mm3, respectively, postoperatively. Median nerve swelling at the proximal carpal tunnel level was observed in 29 (94%) and 23 (74%) patients before and after surgery, respectively. The mean preoperative CSA and CSV values at the hamate level significantly increased from 9.9 to 12.3 mm2 and from 10.9 to 13.5 mm3 after surgery, respectively. Nerve narrowing at the hamate bone level was preoperatively observed in 28 (90%) patients and postoperatively in 21 (68%) patients. Preoperative CSA and CSV values at the proximal carpal tunnel were significantly associated with preoperative distal motor and sensory latency. Conclusions: Visual confirmation of the median nerve morphology using 3-D MRI is useful when considering postoperative recovery and explaining the nerve condition to the patients. Key Points: • The 3-D morphology of the median nerve after carpal tunnel release can be delineated using 3-D MRI. • Preoperative swelling of the median nerve in the 2-D and 3-D planes reflects the severity of carpal tunnel syndrome. • Visual confirmation of the median nerve morphology is useful when considering median nerve recovery after carpal tunnel release and for explaining the condition of the nerve to patients.

Original languageEnglish
Pages (from-to)3016-3023
Number of pages8
JournalEuropean radiology
Volume32
Issue number5
DOIs
Publication statusPublished - 2022 May

Keywords

  • Carpal tunnel syndrome
  • Magnetic resonance imaging
  • Median nerve
  • Three-dimensional imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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