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

Abstract

• 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.

Peripheral Neuropathy: Detection with Diffusion-Tensor Imaging

“…The technical feasibility of peripheral nerve DTI has been tested before, mostly at the carpal tunnel (8,10,12,(14)(15)(16)(17)(18)20). FA values of upper extremity nerves reported in the literature are similar to the values we report herein, ranging from 0.41 to 0.71 in healthy control groups (12,(14)(15)(16)(17)(18)20).…”

Diffusion Tensor Imaging Adds Diagnostic Accuracy in Magnetic Resonance Neurography

“…So far, DTI has been mainly applied in compression neuropathies with moderate diagnostic accuracy. 16,[18][19][20] However, the diagnostic accuracy of DTI in noncompressive neuropathies has seldom been evaluated. [21][22][23][24] For MRN, a central question in clinical routine is whether DTI provides any added diagnostic value or whether it can be used as a quantitative marker independent from the established T2 signal increase.…”

MR Imaging of the Nerves of the Upper Extremity

“…T2-weighted quantitative mapping, diffusion-weighted, and diffusion tensor sequences are advanced techniques that have been reported in the evaluation of idiopathic carpal tunnel syndrome. [19][20][21][22] MR features associated with the clinical diagnosis of carpal tunnel syndrome include thenar muscle denervation edema and/or atrophy, decreased cross-sectional diameter of the nerve in the carpal tunnel compared with diameter proximal to the tunnel, bowing of the flexor retinaculum, and hyperintensity of the nerve proximal and distal to the compression.…”