A comparison of the performance of anatomical MRI and DTI in diagnosing carpal tunnel syndrome

Koh, Sung Hye; Kwon, Byoung Mog; Park, Chanyeong; Hwang, Su Yeon; Lee, Joon Woo; Kim, Sam Soo

doi:10.1016/j.ejrad.2014.08.007

Cited by 30 publications

(44 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…DTI, with evaluation of the fractional anisotropy and diffusion trace, has been proven to be feasible and capable of detecting median nerve injury in CTS. However, a significant diagnostic advantage of DTI compared with standard MRN or to clinical combined with electrophysiological parameters has not been found so far [33][34][35], which might be due to its low signal-to-noise ratio and low spatial resolution.…”

Section: Mrn In Distally-symmetric Polyneuropathiesmentioning

confidence: 99%

MR Neurography: Diagnostic Imaging in the PNS

2015

View full text Add to dashboard Cite

The diagnostic work-up of peripheral neuropathies is often challenging and is mainly based on a combination of clinical and electrophysiological examinations. One of the most important difficulties is the accurate determination of the lesion site (lesion localization), lesion extension, and spatial lesion dispersion, which all represent essential diagnostic information crucial for finding the correct diagnosis and hence an adequate therapeutic approach. A typical pitfall in the conventional diagnostic reasoning is the differentiation between a distal, complete cross-sectional nerve lesion and a more proximally located, fascicular nerve lesion. Magnetic resonance neurography (MRN) has been proven to be capable of improving the diagnostic accuracy by providing direct, noninvasive visualization of nerve injury with high structural resolution even reaching the anatomical level of single nerve fascicles (fascicular imaging) and at the same time with large anatomical coverage. It is also feasible to detect structural nerve damage earlier and with higher sensitivity than gold-standard nerve conduction studies. The purpose of this study is to review the literature for current developments and advances in MRN for the precise spatial detection of nerve lesions in focal and non-focal disorders of the peripheral nervous system.

show abstract

Section: Mrn In Distally-symmetric Polyneuropathiesmentioning

confidence: 99%

MR Neurography: Diagnostic Imaging in the PNS

2015

View full text Add to dashboard Cite

show abstract

“…Intraobserver reliability of measurement of DTI indexes in peripheral nerves is substantial to almost perfect, whereas interobserver reliability has ranged from moderate to almost perfect. [14][15][16][17] The histopathologic processes involving peripheral nerves that preferentially affect FA, ADC, or diffusivity values is not well established. It has been shown, however, that pathologic processes affecting nerves, particularly after prolonged compression, include one or a combination of these mechanisms, that is, a breakdown of the blood-nerve barrier and vascular congestion, intraneural edema, demyelination, and Wallerian degeneration.…”

Section: Technical Aspects Of Dti Of Peripheral Nervesmentioning

confidence: 99%

“…16 Koh et al compared the diagnostic performance of morphological changes of the median nerve, such as crosssectional area to DTI indexes in those with CTS and healthy volunteers. 17 The analysis included the measurement of differences in the nerve at the level of the DRUJ and the flexor retinaculum. The researchers found no statistically significant differences in sensitivity and specificity between the two techniques in diagnosing CTS.…”

Section: Patients With Carpal Tunnel Syndromementioning

confidence: 99%

Diffusion Tensor Imaging of Peripheral Nerves

Naraghi

Awdeh

Wadhwa

et al. 2015

Semin Musculoskelet Radiol

View full text Add to dashboard Cite

Diffusion tensor imaging (DTI) is a powerful MR imaging technique that can be used to probe the microstructural environment of highly anisotropic tissues such as peripheral nerves. DTI has been used predominantly in the central nervous system, and its application in the peripheral nervous system does pose some challenges related to imaging artifacts, the small caliber of peripheral nerves, and low water proton density. However advances in MRI hardware and software have made it possible to use the technique in the peripheral nervous system and to obtain functional data relating to the effect of pathologic processes on peripheral nerves. This article reviews the imaging principles behind DTI and examines the literature regarding its application in assessing peripheral nerves.

show abstract

“…Fat-saturated, T2-weighted Magnetic Resonance Imaging (MRI) can reveal morphological changes in CTS patients, such as enlarged median nerve, nerve flattening, increased signal intensity of the nerve, and flexor retinaculum bowing [5] . However, the sensitivity and specificity of MRI findings are low [6] .…”

Section: Introductionmentioning

confidence: 99%

Role of Diffusion Tensor Imaging of the Median Nerve in Carpal Tunnel Syndrome: A Case Control Comparative Study with Electrophysiological Tests and Clinical Assessment

M.D.¹,

M.D.²,

Mansour

2018

The Medical Journal of Cairo University

View full text Add to dashboard Cite

Background: Carpal Tunnel Syndrome (CTS) is the most common peripheral neuropathy of an upper extremity. The diagnosis of CTS is commonly based on findings from the medical history, physical examination, and provocative tests. To confirm the diagnosis, some clinician accepts Electrophysiological Studies (EPS) as the reference standard. Diffusion-Tensor Imaging (DTI) is a subtype of diffusion-weighted imaging based on measurement of molecular diffusion along multiple directions in space. Directional anisotropy of water diffusibility can be quantified by imaging indices such as Apparent Diffusion Coefficient (ADC) and Fractional Anisotropy (FA) used to characterize the degree of diffusion anisotropy. Aim of Work: The aim of this study is to study the efficacy of diffusion tensor imaging in the diagnosis of carpal tunnel syndrome. Material and Methods: Twenty-three wrists of 15 healthy subjects and 47 wrists of 31 CTS patients were evaluated with DTI and EPS. FA and ADC of the median nerve were calculated at four locations: Distal radioulnar joint, pisiform bone, hamate bone and hamate hook, and also determined from the whole median nerve. Electrophysiological test, including nerve conduction velocity was also performed for comparison with clinical assessment as a standard of reference. Results: There was a significant difference between healthy individuals and patients with carpal tunnel syndrome (p<0.01 for both FA and ADC). FA value less than 0.54 and ADC value more than 1.19 X 1 0-3 mm 2 /sec might be used in the diagnosis of carpal tunnel syndrome. As regards the DTI results, the sensitivity, specificity, negative predictive value, positive predictive value and accuracy were 97.8%, 95.6%, 95.6%, 97.8% and 97.1% respectively. Conclusion: DTI scan contribute to carpal tunnel syndrome diagnosis on the basis of FA and ADC measurements.

show abstract

A comparison of the performance of anatomical MRI and DTI in diagnosing carpal tunnel syndrome

Cited by 30 publications

References 28 publications

MR Neurography: Diagnostic Imaging in the PNS

MR Neurography: Diagnostic Imaging in the PNS

Diffusion Tensor Imaging of Peripheral Nerves

Role of Diffusion Tensor Imaging of the Median Nerve in Carpal Tunnel Syndrome: A Case Control Comparative Study with Electrophysiological Tests and Clinical Assessment

Contact Info

Product

Resources

About