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Assessment of Median Nerve with MR Neurography by Using Diffusion-Tensor Imaging: Normative and Pathologic Diffusion Values


Guggenberger, Roman; Markovic, Daniel; Eppenberger, Patrick; Chhabra, Avneesh; Schiller, Andreas; Nanz, Daniel; Prüssmann, Klaas; Andreisek, Gustav (2012). Assessment of Median Nerve with MR Neurography by Using Diffusion-Tensor Imaging: Normative and Pathologic Diffusion Values. Radiology, 265(1):194-203.

Abstract

Purpose:To determine normative diffusion values of the median nerve at several anatomic locations in healthy men and women of variable age and to compare these normative values with those in patients with carpal tunnel syndrome.Materials and Methods:After ethics board approval and written informed consent were obtained, 45 healthy volunteers (30 women, 15 men) and 15 patients (10 women, five men) were studied. Volunteers were divided into three age groups. Magnetic resonance (MR) neurography with diffusion-tensor imaging (DTI) was performed in all study participants at 3.0 T by using a single-shot echo-planar imaging sequence (repetition time msec/echo time msec, 10 123/40; b = 1200 sec/mm(2)). Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of the median nerve were determined by two readers at three locations: the levels of the distal radioulnar joint, pisiform bone, and hamate bone.Results:Normative FA and ADC values were calculated for men and women, different age groups, and different anatomic locations. FA and ADC did not differ between men and women (P = .28 and P = .38, respectively). FA decreased and ADC increased when moving from proximal to distal locations (P < .001). FA decreased and ADC increased significantly with age (P < .001). There was a significant difference between healthy volunteers and patients with carpal tunnel syndrome (P < .001 for both FA and ADC). An FA threshold of 0.47 and an ADC threshold of 1.054 × 10(-3) mm(2)/sec might be used in the diagnosis of carpal tunnel syndrome.Conclusion:Normative diffusion values for MR neurography of the median nerve with DTI depend on the anatomic location and age but not on sex. Age-specific FA and ADC threshold values might be used to diagnose carpal tunnel syndrome.© RSNA, 2012.

Purpose:To determine normative diffusion values of the median nerve at several anatomic locations in healthy men and women of variable age and to compare these normative values with those in patients with carpal tunnel syndrome.Materials and Methods:After ethics board approval and written informed consent were obtained, 45 healthy volunteers (30 women, 15 men) and 15 patients (10 women, five men) were studied. Volunteers were divided into three age groups. Magnetic resonance (MR) neurography with diffusion-tensor imaging (DTI) was performed in all study participants at 3.0 T by using a single-shot echo-planar imaging sequence (repetition time msec/echo time msec, 10 123/40; b = 1200 sec/mm(2)). Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of the median nerve were determined by two readers at three locations: the levels of the distal radioulnar joint, pisiform bone, and hamate bone.Results:Normative FA and ADC values were calculated for men and women, different age groups, and different anatomic locations. FA and ADC did not differ between men and women (P = .28 and P = .38, respectively). FA decreased and ADC increased when moving from proximal to distal locations (P < .001). FA decreased and ADC increased significantly with age (P < .001). There was a significant difference between healthy volunteers and patients with carpal tunnel syndrome (P < .001 for both FA and ADC). An FA threshold of 0.47 and an ADC threshold of 1.054 × 10(-3) mm(2)/sec might be used in the diagnosis of carpal tunnel syndrome.Conclusion:Normative diffusion values for MR neurography of the median nerve with DTI depend on the anatomic location and age but not on sex. Age-specific FA and ADC threshold values might be used to diagnose carpal tunnel syndrome.© RSNA, 2012.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
04 Faculty of Medicine > Institute of Biomedical Engineering
Dewey Decimal Classification:170 Ethics
610 Medicine & health
Language:English
Date:2012
Deposited On:04 Sep 2012 12:42
Last Modified:05 Apr 2016 15:57
Publisher:Radiological Society of North America
ISSN:0033-8419
Publisher DOI:https://doi.org/10.1148/radiol.12111403
PubMed ID:22820733

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