PMID- 33171617
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201201
IS  - 2075-4418 (Print)
IS  - 2075-4418 (Electronic)
IS  - 2075-4418 (Linking)
VI  - 10
IP  - 11
DP  - 2020 Nov 8
TI  - Quantitative Evaluation of the Echo Intensity of Paraneural Area and Myofascial 
      Structure around Median Nerve in Carpal Tunnel Syndrome.
LID - 10.3390/diagnostics10110914 [doi]
LID - 914
AB  - The aim of this study was to investigate whether the echo intensity (EI) of the 
      paraneural area (PA), the median nerve (MN) at the carpal tunnel, the EI of the 
      myofascial structure (MS) around MN, the 'PA and MN' at the mid-forearm, and the 
      MN transversal displacement at both sites differs between persons with carpal 
      tunnel syndrome (CTS) and control subjects. METHODS: In total, 16 CTS patients 
      and 16 controls, age- and gender-matched, were recruited. Cross-sectional 
      ultrasound images of MN were obtained to evaluate the EI of the PA, the MN at 
      carpal tunnel, the EI of MS, and the 'PA and MN' at the mid-forearm in a natural 
      position, then images were taken after a whole-hand grasp movement, to evaluate 
      MN transversal displacement. Inter-rater and intra-rater reliability in control, 
      and differences in the EI and MN displacement between CTS and control, were 
      analyzed. In addition, the correlations between ultrasound parameters and MN 
      displacement were evaluated. RESULTS: The quantitative EI of PA, MN, EI of MS, 
      'PA and MN' had high inter-rater and intra-rater reliability in the control. The 
      EI of PA, MS and 'PA and MN' were significantly higher in CTS subjects (p < 
      0.01), whilst there was no significant difference in the EI of MN at the carpal 
      tunnel. MN displacement was significantly decreased both at the carpal tunnel and 
      the mid-forearm in CTS subjects (p < 0.01). In addition, there were negative 
      correlations among the EI of PA (rs = -0.484, p = 0.004), EI of MS (rs = -0.479, 
      p = 0.002), EI of 'PA and MN' (rs = -0.605, p < 0.001) and MN transversal 
      displacement. CONCLUSIONS: The higher EI of PA and MS around MN in CTS may 
      indicate greater fibrosis along the course of MN, reducing fascial adaptability, 
      influencing the synergy and coordination of the MS, and increasing the shear 
      stress between MS and MN, and it may further increase the abnormal pressure on 
      the MN not only at the carpal tunnel, but also at the mid-forearm. These results 
      may partly explain the role of PA and MS in CTS pathogenesis.
FAU - Fan, Chenglei
AU  - Fan C
AUID- ORCID: 0000-0002-1129-0379
AD  - Department of Neurosciences, Institute of Human Anatomy, University of Padua, 
      35121 Padua, Italy.
FAU - Fede, Caterina
AU  - Fede C
AUID- ORCID: 0000-0002-4372-7889
AD  - Department of Neurosciences, Institute of Human Anatomy, University of Padua, 
      35121 Padua, Italy.
FAU - Pirri, Carmelo
AU  - Pirri C
AUID- ORCID: 0000-0002-0119-6549
AD  - Department of Neurosciences, Institute of Human Anatomy, University of Padua, 
      35121 Padua, Italy.
FAU - Guidolin, Diego
AU  - Guidolin D
AUID- ORCID: 0000-0003-2133-3552
AD  - Department of Neurosciences, Institute of Human Anatomy, University of Padua, 
      35121 Padua, Italy.
FAU - Biz, Carlo
AU  - Biz C
AUID- ORCID: 0000-0001-8517-0057
AD  - Department of Surgery, Oncology and Gastroenterology, Orthopedic Clinic, 
      University of Padua, 35128 Padua, Italy.
FAU - Macchi, Veronica
AU  - Macchi V
AUID- ORCID: 0000-0003-2335-6897
AD  - Department of Neurosciences, Institute of Human Anatomy, University of Padua, 
      35121 Padua, Italy.
FAU - De Caro, Raffaele
AU  - De Caro R
AUID- ORCID: 0000-0002-2307-0277
AD  - Department of Neurosciences, Institute of Human Anatomy, University of Padua, 
      35121 Padua, Italy.
FAU - Stecco, Carla
AU  - Stecco C
AUID- ORCID: 0000-0002-8767-4555
AD  - Department of Neurosciences, Institute of Human Anatomy, University of Padua, 
      35121 Padua, Italy.
LA  - eng
PT  - Journal Article
DEP - 20201108
PL  - Switzerland
TA  - Diagnostics (Basel)
JT  - Diagnostics (Basel, Switzerland)
JID - 101658402
PMC - PMC7695137
OTO - NOTNLM
OT  - carpal tunnel syndrome
OT  - echo intensity
OT  - median nerve
OT  - myofascial structure
OT  - paraneural area
OT  - ultrasound
COIS- The authors declare no conflict of interest.
EDAT- 2020/11/12 06:00
MHDA- 2020/11/12 06:01
PMCR- 2020/11/08
CRDT- 2020/11/11 01:01
PHST- 2020/10/05 00:00 [received]
PHST- 2020/10/28 00:00 [revised]
PHST- 2020/11/04 00:00 [accepted]
PHST- 2020/11/11 01:01 [entrez]
PHST- 2020/11/12 06:00 [pubmed]
PHST- 2020/11/12 06:01 [medline]
PHST- 2020/11/08 00:00 [pmc-release]
AID - diagnostics10110914 [pii]
AID - diagnostics-10-00914 [pii]
AID - 10.3390/diagnostics10110914 [doi]
PST - epublish
SO  - Diagnostics (Basel). 2020 Nov 8;10(11):914. doi: 10.3390/diagnostics10110914.