Carpal tunnel: MR imaging

Article Abstract:

Carpal tunnel syndrome (CTS) is characterized by muscle soreness, tenderness and weakness of the muscles of the thumb caused by pressure on the median nerve running through the carpal tunnel of the wrist. Magnetic resonance (MR) imaging was used to examine the appearance of the carpal tunnel to evaluate soft-tissue abnormalities associated with carpal tunnel syndrome. A study using MR imaging was conducted to permit identification of the neurological source of CTS, to assess the damage to the median nerve following entrapment in CTS and to identify reasons for failure in CTS therapy. MR imaging demonstrated swelling within the carpal tunnel, especially at the point where the median nerve runs through the carpal tunnel (combines both sensory and motor functions in the hand). CTS usually occurs between 36 and 60 years of age, and is more than twice as common among women. The dominant hand is often affected and CTS often occurs in persons engaged in activities involving repetitive motion for many years, often associated with various occupations (e.g.,typing, sewing). Prior to the advent of MR, imaging methods did not yield useful diagnostic information in CTS. The most important MR finding was that in cases of CTS there is swelling around the pisiform bone. CTS nerve entrapment, the primary cause of pain, swelling, and weakness of the hand, appears to occur at the point where the median nerve enters the carpal tunnel. This limited study indicates that MR imaging may permit identification of some of the causes of treatment failure in patients with CTS. The two main categories of CTS, as described in the research, are: those involving the bones, leading to narrowing of the carpal tunnel, and, those cases of CTS that lead to increased volume of the contents of the carpal tunnel. Examples of the latter may be an increase in the volume of muscle (related to occupational causes of CTS), fat, or space-occupying lesions (abnormal tissue growth), and edema (fluid build-up leading to swelling).

Diagnosis, Causes of, Hand, Carpal tunnel syndrome, Median nerve, Entrapment neuropathies, Carpal bones, Nerve compression syndromes

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Human leg neuromuscular diseases: P-31 MR spectroscopy

Article Abstract:

Patients with a range of neuromuscular leg diseases, such as Duchenne dystrophy, were imaged using a special form of magnetic resonance (MR) scanning that records energy metabolism in human muscle tissue. MR spectroscopy (MRS) records the release of phosphocreatinine, which is phosphorous in conjunction with creatinine as a byproduct of muscular activity, to inorganic phosphate. MRS showed that during exercise, calf muscles of patients with severely decreased oxygen supply in the leg muscles, resulting in limping, show a greater than normal depletion of phosphocreatinine, a larger fall in pH, and a slower recovery time than normal persons. The range of disease in the study affect muscle tissue uniformly and alter phosphate metabolite ratios in a manner that is efficient in characterizing a specific disease. Muscle strength in the diseases that were studied also reflects the extent of fat infiltration of the muscle, as seen in the leg images.

Neuromuscular diseases, Duchenne muscular dystrophy

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Chronically obstructed sinonasal secretions: observations on T1 and T2 shortening

Article Abstract:

Magnetic resonance (MR) imaging technique was tested in cases of inflammation of sinonasal tissues, the tissue in the sinuses and nasal passages. The research was not undertaken in order to diagnose inflammation of the sinonasal tissues but to subject MR signals to a test that assessed their ability to characterize tissue that is high in water and protein content. Thus far, tissue that is high in water and protein content has proven difficult to properly assess through the use of MR diagnostic imaging techniques. Forty- one patients with clinically proven, chronically obstructed sinonasal secretions were studied. The results of this study will be used as a means of improving MR imaging techniques when diagnosis must take place in areas of the body where macromolecular protein concentration, the amount of free water, and the specimen viscosity are likely to cause disturbances or distortions in magnetic resonance signals.

Analysis, Proteins, Paranasal sinuses

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