Diffusion tensor imaging of mild-moderate carpal tunnel syndrome: correlation with nerve conduction study and clinical tests
Diffusion tensor imaging of mild-moderate carpal tunnel syndrome: correlation with nerve conduction study and clinical tests
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DOI：
10.1007/s10067-016-3463-y
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发表时间：
2017-10-01
影响因子：
3.4
通讯作者：
Alrefey, Nora
中科院分区：
文献类型：
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作者：
Razek, Ahmed Abdel Khalek Abdel;Shabana, Adel Abd Elsalam;Alrefey, Nora
本研究的目的是评估扩散张量成像在轻中度腕管综合征（CTS）诊断中的作用，并将分数各向异性（FA）和表观扩散系数（ADC）与神经传导研究和临床试验相关联。本前瞻性研究纳入39例早期CTS患者（男9例，女30例，平均年龄33岁）。20名年龄和性别匹配的健康志愿者作为对照组。所有患者都进行了临床检查和神经传导研究，并计算了远端运动潜伏期（DML）和远端感觉潜伏期（DSL）。CTS患者和志愿者接受正中神经弥散张量成像。计算正中神经的横截面积（CSA）、FA和ADC。FA和ADC在患者和对照组之间（P = 0.001）以及轻度和中度CTS之间（P = 0.001）有显著差异。用于诊断CTS的正中神经截断FA和ADC分别为0.45和1.31 × 10(-3) mm(2)/s，曲线下面积（AUC）分别为0.985和0.954，用于区分轻度和中度CTS的值分别为0.42和1.35 × 10(-3) mm(2)/s， AUC分别为0.964和0.688。正中神经FA、ADC与CSA （r = 0.894; -0.769）、DML （r = -0.935; 0.781）、DSL （r = -0.953; 0.781）、Tinel检验（r = 0.742; 0.684）、Phalen检验（r = 0.862; 0.742）相关。弥散张量成像可用于轻中度CTS的诊断，与神经传导研究和临床检查有良好的相关性。
The purpose of this study was to assess diffusion tensor imaging in the diagnosis of mild-moderate carpal tunnel syndrome (CTS) and to correlate fractional anisotropy (FA) and apparent diffusion coefficient (ADC) with nerve conduction study and clinical tests. This prospective study was conducted upon 39 patients (9 males, 30 females; mean age = 33 years) with early stage of CTS. Twenty age- and sex-matched healthy volunteers were included as a control group. All patients underwent clinical tests and nerve conduction studies with calculation of the distal motor latency (DML) and distal sensory latency (DSL). Patients with CTS and volunteers underwent diffusion tensor imaging of the median nerve. The cross-sectional area (CSA), FA, and ADC of the median nerve were calculated. There was significant difference in FA and ADC between patients and controls (P = 0.001 respectively) and between mild and moderate CTS (P = 0.001 respectively). The cutoff FA and ADC of the median nerve used for the diagnosis of CTS were 0.45 and 1.31 x 10(-3) mm(2)/s with areas under the curve (AUC) of 0.985 and 0.954, respectively, and the values used to differentiate mild from moderate CTS were 0.42 and 1.35 x 10(-3) mm(2)/s with AUC of 0.964 and 0.688, respectively. The FA and ADC of the median nerve were correlated with CSA (r = 0.894; -0.769), DML (r = -0.935; 0.781), DSL (r = -0.953; 0.781), Tinel's test (r = 0.742; 0.684), and Phalen's test (r = 0.862; 0.742). Diffusion tensor imaging can be used for the diagnosis of mild-moderate CTS and well correlated with nerve conduction studies and clinical tests.