PMC4899561_01
Axial CT above the carpal tunnel demonstrates a fasciculated appearance to an enlarged median nerve (arrow) with fat between the fascicles.. Axial CT just past carpal tunnel shows fat between nerve bundles of the median nerve (arrow) that are beginning to diverge.. Axial CT distal to the carpal tunnel shows fat surrounding the fascicles that are now grouped into three digital bundles (arrows) of the median nerve. The nerve fibers demonstrate a coaxial-cable-like appearance.
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Axial CT images were obtained at 2mm increments (Fig. 1A-C). CT demonstrated an enlarged median nerve proximal to the carpal tunnel (Fig. 1A). At the level of the carpal tunnel, CT demonstrated separation of the nerve fascicles by soft tissue with a component of fatty density isodense to subcutaneous fat (Fig. 1B). Distal to the carpal tunnel, CT demonstrated dorsal displacement of the flexor tendons and enlargement of the median nerve (Figure 1a, Figure 2). In addition, the nerve bundles splayed out to their respective digits with innumerable fascicles separated by fat (Figure 1a, Figure 3).
Sagittal 2-D reformat shows nerve bundles contiguous with the palmar aspect of the third flexor tendon. The fascicles demonstrate a spaghetti-like appearance.
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Distal to the carpal tunnel, CT demonstrated dorsal displacement of the flexor tendons and enlargement of the median nerve (Figure 1a, Figure 2).
Coronal 2-D CT reformat shows branching of median nerve distal to the carpal tunnel, with conspicuous nerve bundles surrounded by fat (arrows).
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In addition, the nerve bundles splayed out to their respective digits with innumerable fascicles separated by fat (Figure 1a, Figure 3).