特发性腕管综合征与腕部疾病患者腕关节MRI腕横韧带形态的研究

Study on the idiopathic CTS and transverse carpal ligament of wrist joints of patients with wrist disease in MRI

目的:探讨特发性腕管综合征(CTS)与无腕管综合征和无腕横韧带病变的腕部疾病患者腕关节磁共振成像(MRI)腕横韧带形态分析及诊断意义。方法:回顾性选取50例特发性CTS患者(51个腕关节)纳入观察组,选取同期检查的50例非腕管综合征的其他腕部疾病的患者(50个腕关节)纳入对照组。两组患者均给予横轴面和矢状面腕关节MRI平扫,分析其腕横韧带形态,判断是否为马鞍形,并且计算两组患者的正中神经压缩率和腕横韧带凹曲率等。结果:观察组中有90.20%的患者出现马鞍形腕横韧带,且显著高于对照组患者的34.00%,两组比较差异有统计学意义(x^2=17.284,P<0.05);观察组患者的腕横韧带掌凹曲率为8.38%,对照组的凹曲率为0,两组比较差异有统计学意义(Z=-4.938,P<0.05)。特发性CTS患者的腕横韧带掌凹曲率在其正中神经层面为(7.92±4.31)%,且正中神经压缩率为(39.22±19.28)%,两者为正相关(r=0.723,P<0.05)。结论:临床上特发性CTS患者的腕横韧带为马鞍形,其正中神经压缩率和腕横韧带的矢状面掌凹曲率可以作为特发性CTS患者的精确诊断。

Objective: To explore the morphological analysis and diagnostic significance of idiopathic carpal tunnel syndrome(CTS) and transverse carpal ligament of wrist joints of patients with wrist disease who didn’t have CTS and didn’t have lesion at transverse carpal ligament in magnetic resonance imaging(MRI). Methods: 50 patients(51 wrist joints) with idiopathic CTS were retrospectively divided into observation group, and 50 patients with other wrist disease who didn’t have CTS and received examination at the same term were divided into control group. Both two groups underwent MRI plain scanning for wrist joint on horizontal axis plane and vertical plane, and their morphologies of transverse carpal ligament were analyzed and were judged whether they were saddle-shape, and then the compression ratio of median nerve, concave curvature of transverse carpal ligament and so on of these patients in two groups were calculated. Results: In experimental group, 90.20% of the patients showed a saddle-shape transverse carpal ligament, which was significantly higher than that(34.00%) of control group.(x^2=17.284, P<0.05). The difference of concave curvature of transverse carpal ligament between observation group(8.38%) and control group(0%) was significant(Z=-4.938, P<0.05). And the concave curvature of transverse carpal ligament in the lay of median nerve of patients with idiopathic CTS was(7.92±4.31)%, and compression ratio of median nerve was(39.22±19.28)%, and there was a positive correlation between them(r=0.723, P<0.05). Conclusion: The transverse carpal ligament of clinical patients with idiopathic CTS was saddle-shape, and the compression ratio of median nerve and concave curvature of vertical plane of transverse carpal ligament of them can be used as accurate diagnosis for patients with idiopathic CTS.