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01.10.2013 | Scientific Article

Diffusion tensor imaging of the median nerve before and after carpal tunnel release in patients with carpal tunnel syndrome: feasibility study

verfasst von: Ali Naraghi, Lucas da Gama Lobo, Ravi Menezes, Monica Khanna, Marshall Sussman, Dimitri Anastakis, Lawrence M. White

Erschienen in: Skeletal Radiology | Ausgabe 10/2013

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Abstract

Objectives

To evaluate diffusion tensor imaging (DTI) indices of the median nerve pre and postoperatively in patients with carpal tunnel syndrome (CTS) to determine whether indices acquired prior to surgery differ from those acquired postoperatively.

Methods

Following IRB approval, ten patients with a diagnosis of CTS were prospectively recruited. Eight patients completed the study (seven women, one man). All had bilateral asymmetric symptoms, with subsequent carpal tunnel release on the more symptomatic side. DTI of both wrists were performed using single-shot spin-echo echo-planar imaging (TR/TE, 7,000/103 ms; b value 1,025 s/mm²) preoperatively, 6 weeks and 6 months after carpal tunnel release. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of the median nerve at the level of the distal radioulnar joint and pisiform were determined by one investigator blinded to clinical data, side, and time relative to surgery.

Results

All patients had resolution of symptoms on the surgical side at 6 months. A significant increase in FA (p = 0.018) and decrease in ADC (p = 0.017) were found proximally at 6 months compared to baseline on the operative side. A significant increase in FA was observed on the operative side distally at 6 weeks (p = 0.012) and 6 months (p = 0.017). There was a significant difference in the percentage change in FA values from baseline to 6 months on the operative side in comparison with the non-operative side (p = 0.017).

Conclusions

A significant increase in FA and decrease in ADC of the median nerve are seen following decompression surgery in patients with CTS.

Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosen I. Prevalence of carpal tunnel syndrome in a general population. JAMA. 1999;282(2):153–8.PubMedCrossRef

Hunt TR, Osterman AL. Complications of the treatment of carpal tunnel syndrome. Hand Clin. 1994;10(1):63–71.PubMed

Kessler FB. Complications of the management of carpal tunnel syndrome. Hand Clin. 1986;2(2):401–6.PubMed

Jarvik JG, Yuen E, Haynor DR, Bradley CM, Fulton-Kehoe D, Smith-Weller T, et al. MR nerve imaging in a prospective cohort of patients with suspected carpal tunnel syndrome. Neurology. 2002;58(11):1597–602.PubMedCrossRef

Radack DM, Schweitzer ME, Taras J. Carpal tunnel syndrome: are the MR findings a result of population selection bias? AJR Am J Roentgenol. 1997;169(6):1649–53.PubMedCrossRef

Bammer R. Basic principles of diffusion-weighted imaging. Eur J Radiol. 2003;45(3):169–84.PubMedCrossRef

Le Bihan D, van Zijl P. From the diffusion coefficient to the diffusion tensor. NMR Biomed. 2002;15(7–8):431–4.PubMedCrossRef

Raybaud C, Shroff M, Rutka JT, Chuang SH. Imaging surgical epilepsy in children. Childs Nerv Syst. 2006;22(8):786–809.PubMedCrossRef

Inoue T, Ogasawara K, Beppu T, Ogawa A, Kabasawa H. Diffusion tensor imaging for preoperative evaluation of tumor grade in gliomas. Clin Neurol Neurosurg. 2005;107(3):174–80.PubMedCrossRef

10.

Kabakci N, Gurses B, Firat Z, Bayram A, Ulug AM, Kovanlikaya A, et al. Diffusion tensor imaging and tractography of median nerve: normative diffusion values. AJR Am J Roentgenol. 2007;189(4):923–7.PubMedCrossRef

11.

Tsuchiya K, Fujikawa A, Tateishi H, Nitatori T. Visualization of cervical nerve roots and their distal nerve fibers by diffusion-weighted scanning using parallel imaging. Acta Radiol. 2006;47(6):599–602.PubMedCrossRef

12.

Khalil C, Hancart C, Le Thuc V, Chantelot C, Chechin D, Cotten A. Diffusion tensor imaging and tractography of the median nerve in carpal tunnel syndrome: preliminary results. Eur Radiol. 2008;18(10):2283–91.PubMedCrossRef

13.

Stein D, Neufeld A, Pasternak O, Graif M, Patish H, Schwimmer E, et al. Diffusion tensor imaging of the median nerve in healthy and carpal tunnel syndrome subjects. J Magn Reson Imaging. 2009;29(3):657–62.PubMedCrossRef

14.

Andreisek G, White LM, Kassner A, Sussman MS. Evaluation of diffusion tensor imaging and fiber tractography of the median nerve: preliminary results on intrasubject variability and precision of measurements. AJR Am J Roentgenol. 2010;194(1):W65–72.PubMedCrossRef

15.

Yao L, Gai N. Median nerve cross-sectional area and MRI diffusion characteristics: normative values at the carpal tunnel. Skeletal Radiol. 2009;38(4):355–61.PubMedCrossRef

16.

Skorpil M, Engstrom M, Nordell A. Diffusion-direction-dependent imaging: a novel MRI approach for peripheral nerve imaging. Magn Reson Imaging. 2007;25(3):406–11.PubMedCrossRef

17.

Meek MF, Stenekes MW, Hoogduin HM, Nicolai JP. In vivo three-dimensional reconstruction of human median nerves by diffusion tensor imaging. Exp Neurol. 2006;198(2):479–82.PubMedCrossRef

18.

Hiltunen J, Suortti T, Arvela S, Seppa M, Joensuu R, Hari R. Diffusion tensor imaging and tractography of distal peripheral nerves at 3 T. Clin Neurophysiol. 2005;116(10):2315–23.PubMedCrossRef

19.

Hiltunen J, Kirveskari E, Numminen J, Lindfors N, Goransson H, Hari R. Pre- and post-operative diffusion tensor imaging of the median nerve in carpal tunnel syndrome. Eur Radiol. 2012;22(6):1310–9.PubMedCrossRef

20.

Graham B, Regehr G, Naglie G, Wright JG. Development and validation of diagnostic criteria for carpal tunnel syndrome. J Hand Surg Am. 2006;31(6):919–24.PubMed

21.

Andreisek G, White LM, Kassner A, Tomlinson G, Sussman MS. Diffusion tensor imaging and fiber tractography of the median nerve at 1.5T: optimization of b value. Skeletal Radiol. 2009;38(1):51–9.PubMedCrossRef

22.

Jiang H, van Zijl PC, Kim J, Pearlson GD, Mori S. DtiStudio: resource program for diffusion tensor computation and fiber bundle tracking. Comput Methods Programs Biomed. 2006;81(2):106–16.PubMedCrossRef

23.

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.PubMedCrossRef

24.

, Kimble F, Gulyas K, Ball J. Can the outcome of open carpal tunnel release be predicted?: a review of the literature. ANZ J Surg. 2010; 80(1–2):50–54.

25.

Naidu SH, Fisher J, Heistand M, Kothari MJ. Median nerve function in patients undergoing carpal tunnel release: pre- and post-op nerve conductions. Electromyogr Clin Neurophysiol. 2003;43(7):393–7.PubMed

26.

Pensy RA, Burke FD, Bradley MJ, Dubin NH, Wilgis EF. A 6-year outcome of patients who cancelled carpal tunnel surgery. J Hand Surg Eur Vol. 2011;36(8):642–7.PubMedCrossRef

27.

Khalil C, Budzik JF, Kermarrec E, Balbi V, Le Thuc V, Cotten A. Tractography of peripheral nerves and skeletal muscles. Eur J Radiol. 2010;76(3):391–7.PubMedCrossRef

28.

Kabakci NT, Kovanlikaya A, Kovanlikaya I. Tractography of the median nerve. Semin Musculoskelet Radiol. 2009;13(1):18–23.PubMedCrossRef

29.

Mackinnon SE. Pathophysiology of nerve compression. Hand Clin. 2002;18(2):231–41.PubMedCrossRef

30.

Sunderland S. The nerve lesion in the carpal tunnel syndrome. J Neurol Neurosurg Psychiatry. 1976;39(7):615–26.PubMedCrossRef

31.

Keir PJ, Rempel DM. Pathomechanics of peripheral nerve loading. Evidence in carpal tunnel syndrome J Hand Ther. 2005;18(2):259–69.CrossRef

32.

Guggenberger R, Markovic D, Eppenberger P, Chhabra A, Schiller A, Nanz D, et al. Assessment of median nerve with MR neurography by using diffusion-tensor imaging: normative and pathologic diffusion values. Radiology. 2012;265(1):194–203.PubMedCrossRef

33.

DeLano MC, Cao Y. High b-value diffusion imaging. Neuroimaging Clin N Am. 2002;12(1):21–34.PubMedCrossRef

34.

Kim HJ, Choi CG, Lee DH, Lee JH, Kim SJ, Suh DC. High-b-value diffusion-weighted MR imaging of hyperacute ischemic stroke at 1.5T. AJNR Am J Neuroradiol. 2005;26(2):208–15.PubMed

35.

Thomalla G, Glauche V, Koch MA, Beaulieu C, Weiller C, Rother J. Diffusion tensor imaging detects early Wallerian degeneration of the pyramidal tract after ischemic stroke. NeuroImage. 2004;22(4):1767–74.PubMedCrossRef

36.

Keberle M, Jenett M, Kenn W, Reiners K, Peter M, Haerten R, et al. Technical advances in ultrasound and MR imaging of carpal tunnel syndrome. Eur Radiol. 2000;10(7):1043–50.PubMedCrossRef

37.

Altinok T, Baysal O, Karakas HM, Sigirci A, Alkan A, Kayhan A, et al. Ultrasonographic assessment of mild and moderate idiopathic carpal tunnel syndrome. Clin Radiol. 2004;59(10):916–25.PubMedCrossRef

38.

Guggenberger R, Nanz D, Puippe G, Rufibach K, White LM, Sussman MS, et al. Diffusion tensor imaging of the median nerve: intra-, inter-reader agreement, and agreement between two software packages. Skeletal Radiol. 2011;41(8):971–80.PubMedCrossRef

Titel: Diffusion tensor imaging of the median nerve before and after carpal tunnel release in patients with carpal tunnel syndrome: feasibility study
verfasst von: Ali Naraghi
Lucas da Gama Lobo
Ravi Menezes
Monica Khanna
Marshall Sussman
Dimitri Anastakis
Lawrence M. White
Publikationsdatum: 01.10.2013
Verlag: Springer Berlin Heidelberg
Erschienen in: Skeletal Radiology / Ausgabe 10/2013
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-013-1670-z

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Diffusion tensor imaging of the median nerve before and after carpal tunnel release in patients with carpal tunnel syndrome: feasibility study