European Radiology

, Volume 24, Issue 3, pp 559–565 | Cite as

High-resolution MRI predicts steroid injection response in carpal tunnel syndrome patients

  • Takatoshi AokiEmail author
  • Takahisa Oshige
  • Atsushi Matsuyama
  • Hodaka Oki
  • Shunsuke Kinoshita
  • Yoshiko Yamashita
  • Hiroyuki Takahashi
  • Yoshiko Hayashida
  • Akinori Sakai
  • Masanori Hisaoka
  • Yukunori Korogi



To correlate median nerve T2 signal and shape at the carpal tunnel with steroid injection (SI) response in carpal tunnel syndrome (CTS) patients.


One hundred and sixty-three CTS wrists of 92 consecutive patients who were scheduled to undergo SI were prospectively evaluated with 3-T magnetic resonance imaging (MRI) and a nerve conduction study. All patients underwent axial high-resolution T2-weighted MRI (in-plane resolution of 0.25 × 0.25 mm). The CTS wrists were classified into three groups according to the nerve T2 signal and the flattening ratio at the hook of hamate level: group 1, high and oval; group 2, high and flat; group 3, low and flat. Clinical response to SI was evaluated at 6 months after injection.


One hundred and thirteen of the 163 wrists (69.3 %) responded well to SI. The percentage of improvement was 81.7 % (49/60) in group 1, 69.9 % (51/73) in group 2, and 43.3 % (13/30) in group 3 (P < 0.01). On stepwise logistic regression analysis high-resolution MRI was the only significant independent factor for SI response in CTS patients (P < 0.01).


High-resolution MRI correlates well with SI response in CTS patients and seems useful for predicting SI response.

Key Points

MRI may help determine appropriate care in carpal tunnel syndrome.

MRI helps in therapeutic decision-making whenever steroid injection is considered.

T2 signal decrease of the median nerve correlates with poor outcome.

T2 signal decrease of median nerve may reflect fibrosis and amyloid deposition.


MRI Carpal tunnel syndrome Steroid injection Wrist 3 tesla 



Carpal tunnel syndrome


Nerve conduction study


Steroid injection


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Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Takatoshi Aoki
    • 1
    Email author
  • Takahisa Oshige
    • 2
  • Atsushi Matsuyama
    • 3
  • Hodaka Oki
    • 1
  • Shunsuke Kinoshita
    • 1
  • Yoshiko Yamashita
    • 1
  • Hiroyuki Takahashi
    • 1
  • Yoshiko Hayashida
    • 1
  • Akinori Sakai
    • 2
  • Masanori Hisaoka
    • 3
  • Yukunori Korogi
    • 1
  1. 1.Department of RadiologyUniversity of Occupational and Environmental Health School of MedicineKitakyushuJapan
  2. 2.Department of Orthopaedic SurgeryUniversity of Occupational and Environmental Health School of MedicineKitakyushuJapan
  3. 3.Department of Pathology and OncologyUniversity of Occupational and Environmental Health School of MedicineKitakyushuJapan

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