Current Journal of Neurology

Assessment of median nerve with magnetic resonance neurography in cases with carpal tunnel syndrome and controls

Document Type : Original Article

Authors

Ghasem Farahmand 1
Atefeh Behkar 2
Hassan Hashemi 3
Mahsa Ghajarzadeh 4
Samira Raminfard 5
Mojtaba Shahbazi 1
Payam Sarraf 1

1 Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

2 Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran

3 Radiology Ward, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

4 Brain and Spinal Injury Repair Research Center, Tehran University of Medical Sciences, Tehran, Iran

5 Advanced Medical Technologies and Equipment Institute, Tehran University of Medical Sciences, Tehran, Iran

https://doi.org/http://dx.doi.org/10.18502/cjn.v23i2.16837
Abstract
Background: Carpal tunnel syndrome (CTS) is a common peripheral nerve entrapment disorder that is diagnosed using clinical signs and symptoms and confirmed via nerve conduction studies (NCSs). While NCS is a semi-invasive procedure, magnetic resonance imaging (MRI) is a non-invasive diagnostic tool that detects macroscopic nerve abnormalities and evaluates a patient's surgical or medication treatment options. This study assessed magnetic resonance neurography (MRN)’s diagnostic and grading value by comparing it to electrodiagnostic studies in patients with CTS and healthy individuals.
Methods: This was a cross-sectional study on 27 wrists with CTS and 27 healthy wrists. After history taking and physical examination, we employed an NCS to confirm and determine the severity of CTS, then MRN and diffusion tensor imaging (DTI) were used to calculate apparent diffusion coefficient (ADC), fractional anisotropy (FA), and cross-sectional area (CSA).
Results: 18 patients with CTS (27 median nerves) and 15 healthy controls (27 median nerves) were evaluated. The mean FA in the CTS group was significantly lower (0.38 ± 0.05 vs. 0.45 ± 0.06, P < 0.001). The mean CSA and ADC were higher in patients with CTS but not statistically significant. FA’s diagnostic cut-off was 0.42, with a sensitivity of 70.4% and a specificity of 63%.
Conclusion: MRN with DTI can be an effective and non-invasive diagnostic technique for the detection of CTS. The FA measure demonstrated adequate sensitivity and specificity for differentiating patients with CTS from healthy individuals.

Keywords

Carpal Tunnel Syndrome
Magnetic Resonance Imaging
Diffusion Tensor Imaging
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Current Journal of Neurology
Volume 23, Issue 2
Spring 2024
Pages 89-95

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