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Zhou H, Bai Q, Hu X, Alhaskawi A, Dong Y, Wang Z, Qi B, Fang J, Kota VG, Abdulla MHAH, Ezzi SHA, Lu H. Deep CTS: a Deep Neural Network for Identification MRI of Carpal Tunnel Syndrome. J Digit Imaging 2022; 35:1433-1444. [PMID: 35661280 PMCID: PMC9712834 DOI: 10.1007/s10278-022-00661-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 05/11/2022] [Accepted: 05/23/2022] [Indexed: 10/18/2022] Open
Abstract
Carpal tunnel syndrome (CTS) is a common peripheral nerve disease in adults; it can cause pain, numbness, and even muscle atrophy and will adversely affect patients' daily life and work. There are no standard diagnostic criteria that go against the early diagnosis and treatment of patients. MRI as a novel imaging technique can show the patient's condition more objectively, and several characteristics of carpal tunnel syndrome have been found. However, various image sequences, heavy artifacts, small lesion characteristics, high volume of imagine reading, and high difficulty in MRI interpretation limit its application in clinical practice. With the development of automatic image segmentation technology, the algorithm has great potential in medical imaging. The challenge is that the segmentation target is too small, and there are two categories of images with the proximal border of the carpal tunnel as the boundary. To meet the challenge, we propose an end-to-end deep learning framework called Deep CTS to segment the carpal tunnel from the MR image. The Deep CTS consists of the shape classifier with a simple convolutional neural network and the carpal tunnel region segmentation with simplified U-Net. With the specialized structure for the carpal tunnel, Deep CTS can segment the carpal tunnel region efficiently and improve the intersection over union of results. The experimental results demonstrated that the performance of the proposed deep learning framework is better than other segmentation networks for small objects. We trained the model with 333 images, tested it with 82 images, and achieved 0.63 accuracy of intersection over union and 0.17 s segmentation efficiency, which indicate great promise for the clinical application of this algorithm.
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Affiliation(s)
- Haiying Zhou
- Department of Orthopedics, College of Medicine, The First Affiliated Hospital, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province People’s Republic of China 310003
| | - Qi Bai
- School of Mathematical Sciences, Zhejiang University, #38 Zheda Road, Hangzhou, Zhejiang Province People’s Republic of China 310027
| | - Xianliang Hu
- School of Mathematical Sciences, Zhejiang University, #38 Zheda Road, Hangzhou, Zhejiang Province People’s Republic of China 310027
| | - Ahmad Alhaskawi
- Department of Orthopedics, College of Medicine, The First Affiliated Hospital, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province People’s Republic of China 310003
| | - Yanzhao Dong
- Department of Orthopedics, College of Medicine, The First Affiliated Hospital, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province People’s Republic of China 310003
| | - Zewei Wang
- Zhejiang University School of Medicine, #866 Yuhangtang Road, Hangzhou, Zhejiang Province People’s Republic of China 3100058
| | - Binjie Qi
- Department of Rehabilitation Medicine, College of Medicine, The First Affiliated Hospital, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province People’s Republic of China 310003
| | - Jianyong Fang
- Suzhou Warrior Pioneer Software Co., Ltd, Room 26, Building 17, No. 6, Trade City, Wuzhong Economic Development Zone, Suzhou, Jiangsu Province People’s Republic of China 215000
| | - Vishnu Goutham Kota
- Zhejiang University School of Medicine, #866 Yuhangtang Road, Hangzhou, Zhejiang Province People’s Republic of China 3100058
| | | | - Sohaib Hasan Abdullah Ezzi
- Zhejiang University School of Medicine, #866 Yuhangtang Road, Hangzhou, Zhejiang Province People’s Republic of China 3100058
| | - Hui Lu
- Department of Orthopedics, College of Medicine, The First Affiliated Hospital, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province People’s Republic of China 310003
- Alibaba-Zhejiang University Joint Research Center of Future Digital Healthcare, Zhejiang University, #866 Yuhangtang Road, Hangzhou, Zhejiang Province People’s Republic of China 310058
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Liu Y, Zhuang Y, Wei R, Tan Z, Chen C, Yang D. Comparison of characteristics between neuropathic pain and non-neuropathic pain in patients with diabetic carpal tunnel syndrome: A cross-sectional study. Front Surg 2022; 9:961616. [PMID: 35983551 PMCID: PMC9379137 DOI: 10.3389/fsurg.2022.961616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe aim of the study was to compare the clinical characteristics of diabetic carpal tunnel syndrome between patients with neuropathic pain (NeuP) and non-NeuP.MethodsWe enrolled 276 patients with diabetic carpal tunnel syndrome. Pain symptoms were evaluated using a visual analog scale. Douleur Neuropathique 4, the Neuropathic Pain Symptoms Inventory questionnaire, and the body map were used to assess neuropathic symptoms. Baseline information, clinical manifestations, electrophysiological test results, and psychological status were compared between the neuropathic pain (NeuP) and non-NeuP to identify the risk factor for NeuP occurrence.ResultsResults showed that the degree of pain was more severe in NeuP patients than in nociceptive pain patients (p = 0.025). The frequencies of light touch and pinprick were more pronounced in the NeuP group than in the non-NeuP group (light touch: p = 0.001; pinprick: p = 0.004). There were 48 and 27 NeuP patients with extramedian and proximal spread, respectively, whereas in the non-NeuP group, there were 11 and 9 patients, respectively (p = 0.03). Electrophysiological results showed that patients in the NeuP group exhibited greater sensory nerve conduction velocity impairment compared with the non-NeuP group (p = 0.033). Pain Catastrophizing Scale total scores of the NeuP group were significantly higher than those of the non-NeuP group (p = 0.006).ConclusionOf the 276 diabetic carpal tunnel syndrome patients studied, the majority had NeuP. Furthermore, light touch, electrophysiological test results, and psychological factors were found to be related to NeuP occurrence in patients with diabetic carpal tunnel syndrome.
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Affiliation(s)
- Yingnan Liu
- The Second Clinical Medical College of Jinan University, Shenzhen, Guangdong, China
- Department of Hand and Microvascular Surgery, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Yongqing Zhuang
- The Second Clinical Medical College of Jinan University, Shenzhen, Guangdong, China
- Department of Hand and Microvascular Surgery, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Ruihong Wei
- The Second Clinical Medical College of Jinan University, Shenzhen, Guangdong, China
- Department of Hand and Microvascular Surgery, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Zhouyong Tan
- The Second Clinical Medical College of Jinan University, Shenzhen, Guangdong, China
- Department of Hand and Microvascular Surgery, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Chao Chen
- The Second Clinical Medical College of Jinan University, Shenzhen, Guangdong, China
- Department of Hand and Microvascular Surgery, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Dazhi Yang
- The Second Clinical Medical College of Jinan University, Shenzhen, Guangdong, China
- Department of Spine Surgery, Shenzhen People's Hospital, Shenzhen, Guangdong, China
- Correspondence: Dazhi Yang
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