Cross Sectional Area Change Of The Median Nerve at Different Stages of Carpal Tunnel Syndrome

Objectives. Assessment of changes of cross-sectional area (CSA) on different segments of median nerve at different stages of carpal tunnel syndrome (CTS). Methods and materials. The study included 62 patients divided into two groups. In the basic group examined 48 (77%) patients (dominated by women - 36 (75%)), aged 21-86 years (mean age - 56,7 ± 3,99) with clinical picture of CTS and 85 median nerves were studied. 14 (23%) healthy individuals (dominated by women - 10 (71%)), aged 21-53 years (mean - 35,07 ± 6,22) with 23 median nerves studied served as a control. The degree of neuropathy was established by electrophysiological study (Nicolet Viking Select). According to nerve conduction data the different degree of median nerve injury were established: mild -17 (20%), moderate - 44 (52%), severe - 20 (24%), extreme - 4 (5%). CSA was measured by ultrasonography (10-14 MHz linear-array probe, GE Logiq 9) on antebrachi-um (S1), before the nerve entrance to carpal tunnel (S2), on the level of carpal tunnel (S3) just distal to carpal tunnel (S4), cumulative area of distal median nerve branches (S5). Results. We have found the best correlation between severity of neuropathy and CSA, measured at S2 and S4 on all stages of neuropathy (r +0,69, +0,58; р < 0,05). At stages mild to moderate (with preserved sensory conduction) negative correlation between CSA and sensory nerve conduction velocity on the wrist (r = -0,79; р < 0,05) was found. Conclusion. Increase in CSA of median nerve well correlates with the degree of nerve injury at all stages of CTS. CSA measured at S2 and S4 seems to have better correlation with severity of median nerve neuropathy in CTS in compare with CSA measured on other segments. In patients with preserved sensory conduction increase in CSA accompanied by a decrease in conduction velocity in a segment of the nerve.

невропатия, синдром запястного (карпального) канала, УЗИ периферических нервов, площадь поперечного сечения нерва, электронейромиография, скорость проведения по нерву, neuropathy, carpal tunnel syndrome, high resolution sonography of peripheral nerves, nerve cross-sectional area, nerve conduction study, nerve conduction velocity

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