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Diffusion tensor imaging of the median nerve in recurrent carpal tunnel syndrome - initial experience

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To investigate median nerve structure in patients with recurrent carpal tunnel syndrome (CTS) using diffusion tensor imaging (DTI) and to relate DTI changes to anatomical MRI and to measures of median nerve function.

Methods

Median nerve structure was quantified according to DTI in patients with recurrent CTS and in healthy controls of similar age. Anatomical MRI was used to identify the presence of nerve compression and fibrosis. Median nerve function was measured using electromyography, a force-tracking task (accuracy of precision grip control) and clinical measures.

Results

Patients showed reduced apparent diffusion coefficient (ADC), reduced axial diffusivity (AD) and radial diffusivity (RD) along the median nerve compared with controls (P < 0.001). Patients with endoneural fibrosis had the greatest reductions in ADC and in RD. ADC and AD correlated positively with nerve conduction velocity (R = 0.54 and R = 0.68, respectively) and fractional anisotropy correlated negatively with error during force-tracking (R = -0.58).

Conclusions

A specific pattern of DTI changes in the median nerve was identified in patients with recurrent CTS. Fibrosis may be underlying these structural changes. The correlations with nerve conduction velocity and accuracy of force control suggest that DTI is a promising technique in the study of median nerve structure in recurrent CTS.

Key Points

• Diffusion tensor imaging (DTI) offers further possibilities in musculoskeletal magnetic resonance imaging.

• DTI reveals median nerve changes in recurrent carpal tunnel syndrome.

• DTI changes were greater with signs of median nerve fibrosis.

• DTI parameters correlated with nerve conduction and force control measures.

• DTI is a promising technique in recurrent carpal tunnel syndrome.

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Abbreviations

AD:

Axial diffusivity

ADC:

Apparent diffusion coefficient

Arm_prox:

Forearm proximal to the wrist joint

CT_dist:

Distal carpal tunnel

CT_prox:

Proximal carpal tunnel

CTS:

Carpal tunnel syndrome

EMG:

Electromyography

EPI:

Echo planar imaging

FA:

Fractional anisotropy

MVC:

Maximal voluntary contraction

RD:

Radial diffusivity

SD:

Standard deviation

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Acknowledgements

This study was not supported by any external public grants or private funding. The authors report no conflicts of interest.

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Authors and Affiliations

  1. Service de Radiologie B, APHP, CHU Cochin, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 75014, Paris, France

    Pavel G. Lindberg, Antoine Feydy & Jean-Luc Drapé

  2. Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Recherche (UMR) 8194, 75006, Paris, France

    Pavel G. Lindberg, Antoine Feydy & Marc A. Maier

  3. Université Paris Descartes, Sorbonne Paris Cité, 75006, Paris, France

    Pavel G. Lindberg, Antoine Feydy & Marc A. Maier

  4. Institut de la Main, 75016, Paris, France

    Dominique Le Viet

  5. Université Paris Diderot, Sorbonne Paris Cité, 75205, Paris, France

    Marc A. Maier

  6. CESEM - CNRS UMR 8194, Université Paris Descartes, Sorbonne Paris Cité, 45 rue des Saints Pères, 75270, Paris Cedex 06, France

    Pavel G. Lindberg

Authors
  1. Pavel G. Lindberg
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  2. Antoine Feydy
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  3. Dominique Le Viet
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  4. Marc A. Maier
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  5. Jean-Luc Drapé
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Corresponding author

Correspondence to Pavel G. Lindberg.

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Lindberg, P.G., Feydy, A., Le Viet, D. et al. Diffusion tensor imaging of the median nerve in recurrent carpal tunnel syndrome - initial experience. Eur Radiol 23, 3115–3123 (2013). https://doi.org/10.1007/s00330-013-2986-8

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  • DOI: https://doi.org/10.1007/s00330-013-2986-8

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