Role of diffusion tensor imaging in carpal tunnel syndrome: A case control comparative study to electrophysiological tests and clinical assessment

Wafaie, Ahmed; Afifi, Lamia; Moussa, Kareem; Mansour, Ayman; Abbas, Hoda M.

doi:10.1016/j.ejrnm.2018.06.008

Cited by 10 publications

(20 citation statements)

References 17 publications

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“…Furthermore, the use of diffusion tensor imaging (DTI) has been considered for the efficacy in the diagnosis and management of CTS, resulting to be an important imaging technique which enables visualization and characterization of the median nerve, although the quality of images depends on field homogeneity, coil, as well as the gradient systems used, making it technically challenging. [ 58 ]…”

Section: Discussionmentioning

confidence: 99%

Carpal tunnel syndrome caused by the entrapment of a bifid Lanz IIIA Type anatomical variant of median nerve: A case report and systematic literature review

Corte

Gelmi

Acciarri

2021

Surgical Neurology International

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Background: Carpal tunnel syndrome (CTS) is the most common entrapment peripheral neuropathy. Median nerve may present several anatomical variations such as a high division or bifid median nerve (BMN). A thorough knowledge of the normal anatomy and variations of the median nerve at the wrist are fundamental to reduce complications during carpal tunnel release. Case Description: A 63-year-old man with CTS underwent preoperative ultrasound that showed the entrapment of the median nerve and disclosed a BMN Lanz IIIA Type anatomical variation at the carpal tunnel. During the surgery, the anatomical variant of a BMN at the wrist has been visualized. Both nervous rami entirely occupied the carpal canal and this may have predisposed to the development of the entrapment syndrome. Nor persistent median artery, or other associated abnormalities, have been identified. At the 6 months follow-up control, the patient referred a good surgical recovery with complete resolution of the preoperative symptoms of the median nerve entrapment. Conclusion: A rare case of Lanz IIIA BMN Type at the wrist has been encountered in a patient with a CTS and a systematic review and practical considerations have been presented with the aim of raising awareness to the neurosurgical community of a such rare variant that could be encountered during carpal tunnel release procedures. CTS may be caused by the entrapment of a BMN Lanz IIIA Type anatomical variant of median nerve. Preoperative US would help to identify such patients to reduce risk of iatrogenic injuries.

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Section: Discussionmentioning

confidence: 99%

Carpal tunnel syndrome caused by the entrapment of a bifid Lanz IIIA Type anatomical variant of median nerve: A case report and systematic literature review

Corte

Gelmi

Acciarri

2021

Surgical Neurology International

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“…Ten studies (32%) were performed at a eld strength of 1•5 tesla 17,29,32,35,38,42,44,49,50,52 , twenty one (65%) at 3 tesla 16,19,[26][27][28]30,31,33,34,36,37,[39][40][41]43,[45][46][47][48]51,53 , and one at 7 tesla 18 . The median echo and repetition times were 87ms (IQR 65-91, range 21-103) and 7000ms (IQR 3800-7650, range 1470-10,254), respectively.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The FA of the median nerve in asymptomatic adults was reported in 29 studies [16][17][18][19][26][27][28][29][30][31][32][33][34][35][37][38][39][40][41][43][44][45][46][47][48][49][50][51]53 .…”

Section: Evidence Synthesis: Asymptomatic Adultsmentioning

confidence: 99%

“…Overall, the normal FA was 0•58 (95% CI 0•56, 0•59; I 2 98%). The FA was highest at the level of the DRUJ The MD of the median nerve in asymptomatic adults was reported in 28 studies [16][17][18][19][26][27][28][29][30][31][32][33][34][35][37][38][39][40][41][43][44][45][46][47][48][49][50][51] .…”

Section: Evidence Synthesis: Asymptomatic Adultsmentioning

confidence: 99%

“…Overall, the normal MD was 1•138 x10 - Fourteen studies reported direct comparisons between asymptomatic adults and patients with CTS [16][17][18]27,28,[31][32][33]38,39,44,46,49,50 . All studies reported a lower FA in patients with CTS compared to asymptomatic adults (mean difference 0•09 [95% CI 0•07, 0•11]; Figure 2).…”

Section: Evidence Synthesis: Asymptomatic Adultsmentioning

confidence: 99%

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Diffusion Tensor Imaging of the Median Nerve: A Systematic Review and Meta-Analysis of Normal Values in Asymptomatic Adults and How They Change in Carpal Tunnel Syndrome

Rojoa

Raheman

Rassam

et al. 2021

Preprint

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Background: Carpal tunnel syndrome (CTS) leads to distortion of axonal architecture, demyelination and fibrosis within the median nerve. Diffusion tensor imaging (DTI) characterises tissue microstructure and generates reproducible proxy measures of nerve ‘health’ which are sensitive to myelination, axon diameter, fibre density and organisation. This meta-analysis summarises the normal DTI values of the median nerve, and how they change in CTS.Methods: This systematic review included studies reporting DTI of the median nerve at the level of the wrist in adults. The primary outcome was to determine the normal fractional anisotropy (FA) and mean diffusivity (MD) of the median nerve. Secondarily, we show how the FA and MD differ between asymptomatic adults and patients with CTS, and how these differences are independent of the acquisition methods.Results: 32 studies of 2643 wrists, belonging to 1575 asymptomatic adults and 1068 patients with CTS were included. The normal FA was 0·58 (95% CI 0·56, 0·59) and the normal MD was 1·138 x10-3 mm2/s (95% CI 1·101, 1·174). Patients with CTS had a significantly lower FA than controls (mean difference 0·12 [95% CI 0·09, 0·16]). Similarly, the median nerve of patients with CTS had a significantly higher mean diffusivity (mean difference 0·16 mm2/s x10-3 [95% CI 0·05, 0·27]). The differences were independent of experimental factors.Conclusion: We provide summary estimates of the normal FA and MD of the median nerve in asymptomatic adults. Furthermore, we show that diffusion throughout the length of the median nerve becomes more isotropic in patients with CTS.

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Carpal tunnel syndrome

Harinesan,

Silsby,

Simon

2024

Handbook of Clinical Neurology

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Role of diffusion tensor imaging in carpal tunnel syndrome: A case control comparative study to electrophysiological tests and clinical assessment

Cited by 10 publications

References 17 publications

Carpal tunnel syndrome caused by the entrapment of a bifid Lanz IIIA Type anatomical variant of median nerve: A case report and systematic literature review

Carpal tunnel syndrome caused by the entrapment of a bifid Lanz IIIA Type anatomical variant of median nerve: A case report and systematic literature review

Diffusion Tensor Imaging of the Median Nerve: A Systematic Review and Meta-Analysis of Normal Values in Asymptomatic Adults and How They Change in Carpal Tunnel Syndrome

Carpal tunnel syndrome

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