Carpal tunnel syndrome assessment with diffusion tensor imaging: Value of fractional anisotropy and apparent diffusion coefficient

A. S. Klauser, M. Abd Ellah, C. Kremser, Mihra Taljanovic, G. Schmidle, M. Gabl, F. Cartes-Zumelzu, R. Steiger, E. R. Gizewski

Research output: Contribution to journalArticle

6 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalEuropean Radiology
DOIs
StateAccepted/In press - Sep 27 2017

Fingerprint

Diffusion Tensor Imaging
Carpal Tunnel Syndrome
Anisotropy
Healthy Volunteers
Neural Conduction
Sensitivity and Specificity

Keywords

  • Carpal tunnel syndrome
  • Diffusion tensor imaging
  • Functional magnetic resonance imaging
  • Magnetic resonance imaging
  • Median nerve

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Carpal tunnel syndrome assessment with diffusion tensor imaging : Value of fractional anisotropy and apparent diffusion coefficient. / Klauser, A. S.; Abd Ellah, M.; Kremser, C.; Taljanovic, Mihra; Schmidle, G.; Gabl, M.; Cartes-Zumelzu, F.; Steiger, R.; Gizewski, E. R.

In: European Radiology, 27.09.2017, p. 1-7.

Research output: Contribution to journalArticle

Klauser, A. S. ; Abd Ellah, M. ; Kremser, C. ; Taljanovic, Mihra ; Schmidle, G. ; Gabl, M. ; Cartes-Zumelzu, F. ; Steiger, R. ; Gizewski, E. R. / Carpal tunnel syndrome assessment with diffusion tensor imaging : Value of fractional anisotropy and apparent diffusion coefficient. In: European Radiology. 2017 ; pp. 1-7.
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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.",
keywords = "Carpal tunnel syndrome, Diffusion tensor imaging, Functional magnetic resonance imaging, Magnetic resonance imaging, Median nerve",
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T2 - Value of fractional anisotropy and apparent diffusion coefficient

AU - Klauser, A. S.

AU - Abd Ellah, M.

AU - Kremser, C.

AU - Taljanovic, Mihra

AU - Schmidle, G.

AU - Gabl, M.

AU - Cartes-Zumelzu, F.

AU - Steiger, R.

AU - Gizewski, E. R.

PY - 2017/9/27

Y1 - 2017/9/27

N2 - 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.

AB - 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.

KW - Carpal tunnel syndrome

KW - Diffusion tensor imaging

KW - Functional magnetic resonance imaging

KW - Magnetic resonance imaging

KW - Median nerve

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