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27.09.2017 | Magnetic Resonance

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

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

Erschienen in: European Radiology | Ausgabe 3/2018

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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.

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Titel: Carpal tunnel syndrome assessment with diffusion tensor imaging: Value of fractional anisotropy and apparent diffusion coefficient
verfasst von: A. S. Klauser
M. Abd Ellah
C. Kremser
M. Taljanovic
G. Schmidle
M. Gabl
F. Cartes-Zumelzu
R. Steiger
E. R. Gizewski
Publikationsdatum: 27.09.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 3/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-5046-y

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