Evaluation of median nerve T2 signal changes in patients with surgically treated carpal tunnel syndrome.
OBJECTIVE
To determine the accuracy of median nerve T2 evaluation and its relation with Boston Questionnaire (BQ) and nerve conduction studies (NCSs) in pre-operative and post-operative carpal tunnel syndrome (CTS) patients in comparison with healthy volunteers.


METHODS
Twenty-three CTS patients and 24 healthy volunteers underwent NCSs, median nerve T2 evaluation and self-administered BQ. Pre-operative and 1st year post-operative median nerve T2 values and cross-sectional areas (CSAs) were compared both within pre-operative and post-operative CTS groups, and with healthy volunteers. The relationship between MRI findings and BQ and NCSs was analyzed. The ROC curve analysis was used for determining the accuracy.


RESULTS
The comparison of pre-operative and post-operative T2 values and CSAs revealed statistically significant improvements in the post-operative patient group (p<0.001 for all parameters). There were positive correlations between T2 values at all levels and BQ values, and positive and negative correlations were also found regarding T2 values and NCS findings in CTS patients. The receiver operating characteristic curve analysis for defined cut-off levels of median nerve T2 values in hands with severe CTS yielded excellent accuracy at all levels. However, this accuracy could not be demonstrated in hands with mild CTS.


CONCLUSIONS
This study is the first to analyze T2 values in both pre-operative and post-operative CTS patients. The presence of increased T2 values in CTS patients compared to controls and excellent accuracy in hands with severe CTS indicates T2 signal changes related to CTS pathophysiology and possible utilization of T2 signal evaluation in hands with severe CTS.
Neurosurgery Clinic, Istanbul Training and Research Hospital, Istanbul, Turkey. Electronic address: mysamanci@hotmail.com.
Yavuz
Y
Samanci
Diagnostic and Interventional Radiology Clinic, Istanbul Training and Research Hospital, Istanbul, Turkey.
Yeşim
Y
Karagöz
Neurosurgery Clinic, Istanbul Training and Research Hospital, Istanbul, Turkey.
Mehmet
M
Yaman
Neurosurgery Clinic, Istanbul Training and Research Hospital, Istanbul, Turkey.
İbrahim Burak
İB
Atçı
Neurology Clinic, Istanbul Training and Research Hospital, Istanbul, Turkey.
Ufuk
U
Emre
Diagnostic and Interventional Radiology Clinic, Istanbul Training and Research Hospital, Istanbul, Turkey.
Nuri Özgür
NÖ
Kılıçkesmez
Neurosurgery Clinic, Okmeydani Training and Research Hospital, Istanbul, Turkey.
Suat Erol
SE
Çelik
D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008475:Median Nerve / Q000000981:diagnostic imaging / Q000503:physiopathology; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology*; D011184:Postoperative Period; D057234:Preoperative Period; D016896:Treatment Outcome
Boston questionnaire; Carpal tunnel syndrome; Magnetic resonance imaging; Median nerve; Surgery