Carpal Tunnel Cross-Sectional Area Affected by Soft Tissues Abutting the Carpal Bones.
Carpal Tunnel Cross-Sectional Area Affected by Soft Tissues Abutting the Carpal Bones.
复制标题
腕管横截面面积受软组织影响的腕骨骨骼。
DOI：
10.1055/s-0032-1329593
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发表时间：
2013-02
影响因子：
0.7
通讯作者：
Li ZM
中科院分区：
文献类型：
--
作者：
Gabra JN;Li ZM
腕管容纳其内容物的自由运动，并且腕管的横截面积是用于评价腕管内容物可用的空间和腕管中潜在的神经压迫的有用的形态学参数。腕骨的骨性边界作为腕管的背侧边界通常用于确定腕管区域，但该边界包含软组织，例如许多腕骨间韧带和桡侧腕屈肌腱。本研究的目的是量化的厚度软组织邻接腕骨，并探讨如何影响计算腕管面积的软组织。对8例尸体标本的磁共振图像进行了分析。将具有生理压力的医用球囊插入到抽空的隧道中以识别腕管边界。提取基于球囊的（即真正的腕管）和基于骨的腕管边界，并将其划分为对应于钩骨、头状骨、梯形骨、腕关节和腕横韧带（TCL）的区域。根据这两个边界，计算整体和局部软组织厚度和面积。小斜方骨（3.1±1.2mm）和棘突（3.4±1.0mm）区的软组织厚度明显大于钩骨（0.7±0.3mm）和头状骨（1.2±0.5mm）区。使用骨性边界的腕管面积（243.0±40.4mm2）显著大于基于球囊的面积（183.9±29.7mm2），比值为1.32。换句话说，腕管面积可以估计为基于骨的面积的76%（= 1/1.32）。在小斜方肌和腕关节区丰富的软组织主要是由于头状肌-腕关节韧带和桡侧腕屈肌腱。包括这样的软组织导致高估的腕管面积。正确量化腕管面积有助于检查腕管狭窄作为正中神经压迫的潜在危险因素。
The carpal tunnel accommodates free movement of its contents, and the tunnel’s cross-sectional area is a useful morphological parameter for the evaluation of the space available for the carpal tunnel contents and of potential nerve compression in the tunnel. The osseous boundary of the carpal bones as the dorsal border of the carpal tunnel is commonly used to determine the tunnel area, but this boundary contains soft tissues such as numerous intercarpal ligaments and the flexor carpi radialis tendon. The aims of this study were to quantify the thickness of the soft tissues abutting the carpal bones and to investigate how this soft tissue influences the calculation of the carpal tunnel area. Magnetic resonance images were analyzed for eight cadaveric specimens. A medical balloon with a physiological pressure was inserted into an evacuated tunnel to identify the carpal tunnel boundary. The balloon-based (i.e. true carpal tunnel) and osseous-based carpal tunnel boundaries were extracted and divided into regions corresponding to the hamate, capitate, trapezoid, trapezium, and transverse carpal ligament (TCL). From the two boundaries, the overall and regional soft tissue thicknesses and areas were calculated. The soft tissue thickness was significantly greater for the trapezoid (3.1±1.2mm) and trapezium (3.4±1.0mm) regions than for the hamate (0.7±0.3mm) and capitate (1.2±0.5mm) regions. The carpal tunnel area using the osseous boundary (243.0±40.4mm2) was significantly larger than the balloon-based area (183.9±29.7mm2) with a ratio of 1.32. In other words, the carpal tunnel area can be estimated as 76% (= 1/1.32) of the osseous-based area. The abundance of soft tissue in the trapezoid and trapezium regions can be attributed mainly to the capitate-trapezium ligament and the flexor carpi radialis tendon. Inclusion of such soft tissue leads to overestimations of the carpal tunnel area. Correct quantification of the carpal tunnel area aids in examining carpal tunnel stenosis as a potential risk factor for median nerve compression.