A S Klauser1, M Abd Ellah2,3, C Kremser1, M Taljanovic4, G Schmidle5, M Gabl5, F Cartes-Zumelzu6, R Steiger6, E R Gizewski6. 1. Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria. 2. Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria. dr_m_hamdy2006@hotmail.com. 3. Department of Diagnostic Radiology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt. dr_m_hamdy2006@hotmail.com. 4. Department of Medical Imaging, University of Arizona, College of Medicine, Banner- University Medical Center, Tucson, USA. 5. Department for Trauma Surgery, Medical University of Innsbruck, Innsbruck, Austria. 6. Department of Neuroradiology, Neuroimaging core facility, Medical University of Innsbruck, Innsbruck, Austria.
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.
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.
Entities:
Keywords:
Carpal tunnel syndrome; Diffusion tensor imaging; Functional magnetic resonance imaging; Magnetic resonance imaging; Median nerve
Authors: Lukas Filli; Marco Piccirelli; David Kenkel; Andreas Boss; Andrei Manoliu; Gustav Andreisek; Himanshu Bhat; Val M Runge; Roman Guggenberger Journal: Eur Radiol Date: 2015-09-15 Impact factor: 5.315
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