Carpal tunnel syndrome assessment with diffusion tensor imaging: Value of fractional anisotropy and apparent diffusion coefficient

A. S. Klauser, M. Abd Ellah, C. Kremser, M. Taljanovic, G. Schmidle, M. Gabl, F. Cartes-Zumelzu, R. Steiger, E. R. Gizewski

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Objectives: To quantitatively assess carpal tunnel syndrome (CTS) with DTI by evaluating two approaches to determine cut-off values. Methods: In forty patients with CTS diagnosis confirmed by nerve conduction studies (NCs) and 14 healthy subjects (mean age 58.54 and 57.8 years), cross-sectional area (CSA), apparent diffusion coefficient (ADC) and fractional anisotropy (FA) at single and multiple levels with intraobserver agreement were evaluated. Results: Maximum and mean CSA and FA showed significant differences between healthy subjects and patients (12.85 mm2 vs. 28.18 mm2, p < 0.001, and 0.613 vs. 0.524, p=0.007, respectively) (10.12 mm2 vs. 19.9 mm2, p<0.001 and 0.617 vs. 0.54, p=0.003, respectively), but not maximum and mean ADC (p > 0.05). For cut-off values, mean and maximum CSA showed the same sensitivity and specificity (93.3 %). However, mean FA showed better sensitivity than maximum FA (82.6 % vs. 73.9 %), but lower specificity (66.7 % vs. 80 %), and significant correlation for maximum CSA, 97 % (p < 0.01), with good correlation for maximum ADC and FA, 84.5 % (p < 0.01) and 62 % (p=0.056), respectively. Conclusions: CSA and FA showed significant differences between healthy subjects and patients. Single measurement at maximum CSA is suitable for FA determination. Key Points • DTI showed that FA is stronger than ADC for CTS diagnosis. • Single- and multiple-level approaches were compared to determine FA and ADC. • Single-level evaluation at the thickest MN cross-sectional area is sufficient.

Original languageEnglish (US)
Pages (from-to)1111-1117
Number of pages7
JournalEuropean Radiology
Volume28
Issue number3
DOIs
StatePublished - Mar 1 2018

Keywords

  • Carpal tunnel syndrome
  • Diffusion tensor imaging
  • Functional magnetic resonance imaging
  • Magnetic resonance imaging
  • Median nerve

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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