CAPACITY OF THE MAGNETIC RESONANT TOMOGRAPHY IN DIAGNOSTIC OF THE ARMS ENTRAPMENT NEUROPATHIES IN PATIENTS WITH HYPOTHYROSIS

Symptoms of neuromuscular dysfunction are quite common in patients with hypothyroidism. Structural changes of myelin and dysfunction of oligodendroglial processes in axons have pathogenetic significance in patients with neuropathies against the background of hypothyroidism. However, the etiopathogenesis of the development of neuropathies in hypothyroidism is not fully understood. Magnetic resonance imaging (MRI) is a modern imaging method that now provides an image of nerve trunks with a quality sufficient to assess their condition. The main task of MRI is to assess the difficult and atypical cases of nerve compression. We examined 26 patients diagnosed with hypothyroidism, including 8 patients with degenerative-dystrophic diseases of the spine, 1 patient — an anomaly of nerves and muscles, 2 patients were found to have the consequences of injuries, 1 patient was diagnosed with De-Kervin disease, and 14 patients with comorbidity, leading to nerve compression, was not found. The aim of the study was to assess the diagnostic capabilities of magnetic resonance imaging for compression-ischemic neuropathies of the hands in patients with hypothyroidism. Neurological examination and data from stimulation electroneuromyography allows you to accurately determine the area of investigation for MRI. The article shows the diagnostic capabilities of MRI, as well as its place in the diagnostic algorithm of compression-ischemic neuropathies of the hands in patients with hypothyroidism.

1. Петунина Н.А. и др. Гипотиреоз: подходы к диагностике и лечению // Consilium medicum. 2012. № 2. С. 80–83. [Petunina N.A. et al. Gipotireoz: podhody k diagnostike i lecheniyu. Consilium medicum, 2012, No. 2, рр. 80–83 (In Russ.)].

2. Yeasmin S., Begum N., Begum S., Rahman S. Sensory neuropathy in hypothyroidism: electrophysiological and clinical findings // J. Bangladesh Soc. Physiol. 2007. No. 2. P. 1–6.

3. Одинак М.М., Живолупов С.А. Заболевания и травмы периферическои нервнои системы (обобщение клинического и экспериментального опыта). СПб.: СпецЛит, 2009. 367 с. [Odinak M.M., Zhivolupov S.A. Zabolevaniya i travmy perifericheskoi nervnoi sistemy (obobshchenie klinicheskogo i ehksperimental’nogo opyta). Saint Petersburg: Izdatel’stvo SpecLit, 2009. 367 p. (In Russ.)].

4. Peer S., Bodner G. High Resolution Sonography of the Peripheral Nervous System. Berlin: Springer, 2008. 136 p.

5. Дедов И.И., Мельниченко Г.А. Эндокринология. Нацио нальное руководство. Краткое издание. М.: ГЭОТАР-Медиа, 2013. 752 с. [Dedov I.I., Mel’nichenko G.A. Ehndokrinologiya. Nacional’noe rukovodstvo. Kratkoe izdanie. Moscow: Izdatel’stvo GEHOTAR-Media, 2013. 752 p. (In Russ.)].

6. Спирин Н.Н. и др. Неврологические аспекты нарушения функции щитовидной железы: метод. пособие. Ярославль: Ремдер, 2007. 40 с. [Spirin N.N. et al. Nevrologicheskie aspekty narusheniya funkcii shchitovidnoj zhelezy: metod. posobie. Yаroslavl’: Izdatel’stvo Remder, 2007. 40 p. (In Russ.)].

7. Preston D.C., Shapiro B.E. Electromyography and neuromuscular disorders. Appendix. Nerve conduction studies: normal adult values. Newton: Butterworth-Heinemann, 2nd ed., 2005. P. 561–564.

8. Кunze N.M. Investigation of local deformation of the median nerve in magnetic resonance images of the carpal tunnel. Iowa research online. 2010. 120 p.

9. Иванова Г.П., Горобец Л.Н. Психоиммуноэндокринный статус больных аутоиммунным тиреоидитом (клинико-терапевтические аспекты) // Сибирский вестник психиатрии и наркологии. 2010. № 2 (59). С. 57–62. [Ivanova G.P., Gorobec L.N. Psihoimmunoehndokrinnyj status bol’nyh autoimmunnym tireoiditom (kliniko-terapevticheskie aspekty). Sibirskij vestnik psihiatrii i narkologii, 2010, No. 2 (59), рр. 57–62 (In Russ.)].

10. Никанорова Т.Ю. Неврологические и клинико-иммунологические аспекты первичного гипотиреоза: дис. канд. мед. наук: 14.00.13. Ярославль, 2006. 155 с. [Nikanorova T.Yu. Nevrologicheskie i klinikoimmunologicheskie aspekty pervichnogo gipotireoza: dis. kand. med. nauk: 14.00.13. Yаroslavl’, 2006. 155 p. (In Russ.)].

11. Kimura J. Assessment of individual nerves. Electrodiagnosis in diseases of nerve and muscle: principles and practice. Ed. 3. New York: Oxford University Press, 2001. P. 130–177.

12. Яхно Н.Н., Штульман Д.Р. Болезни нервной системы: руководство для врачей: в 2 т. Т. 1. М.: Медицина, 2007. 744 с. [Yаhno N.N., Shtul’man D.R. Bolezni nervnoj sistemy: rukovodstvo dlya vrachej: v 2 t. T. 1. M.: Medicina, 2007. 744 p. (In Russ.)].

13. Jameson J.L. et al. Disorders of the Thyroid Gland // Harrison’s principles of internal medicine. 15th ed. McGraw-Hill, 2001. P. 2060–2084.

14. Cruz M.W. et al. Electroneuromyography and neuromuscular findings in 16 primary hypothyroidism patients // Arq. Neuropsiquiatr. 1996. No. 54. P. 12–18.

15. Ferreira A.A. et al. Effects of experimental hypothyroidism on myelin sheath structural organization // J. Neurocytol. 2004. No. 33 (2). P. 225–231.