Lindberg Pavel G, Feydy Antoine, Le Viet Dominique, Maier Marc A, Drapé Jean-Luc
Service de Radiologie B, APHP, CHU Cochin, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 75014, Paris, France,
Eur Radiol. 2013 Nov;23(11):3115-23. doi: 10.1007/s00330-013-2986-8. Epub 2013 Aug 27.
To investigate median nerve structure in patients with recurrent carpal tunnel syndrome (CTS) using diffusion tensor imaging (DTI) and to relate DTI changes to anatomical MRI and to measures of median nerve function.
Median nerve structure was quantified according to DTI in patients with recurrent CTS and in healthy controls of similar age. Anatomical MRI was used to identify the presence of nerve compression and fibrosis. Median nerve function was measured using electromyography, a force-tracking task (accuracy of precision grip control) and clinical measures.
Patients showed reduced apparent diffusion coefficient (ADC), reduced axial diffusivity (AD) and radial diffusivity (RD) along the median nerve compared with controls (P < 0.001). Patients with endoneural fibrosis had the greatest reductions in ADC and in RD. ADC and AD correlated positively with nerve conduction velocity (R = 0.54 and R = 0.68, respectively) and fractional anisotropy correlated negatively with error during force-tracking (R = -0.58).
A specific pattern of DTI changes in the median nerve was identified in patients with recurrent CTS. Fibrosis may be underlying these structural changes. The correlations with nerve conduction velocity and accuracy of force control suggest that DTI is a promising technique in the study of median nerve structure in recurrent CTS.
• 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.
使用扩散张量成像（DTI）研究复发性腕管综合征（CTS）患者的正中神经结构，并将DTI变化与解剖学MRI以及正中神经功能测量结果相关联。
对复发性CTS患者和年龄相仿的健康对照者，根据DTI对正中神经结构进行量化。使用解剖学MRI识别神经受压和纤维化的存在。通过肌电图、力跟踪任务（精确抓握控制的准确性）和临床测量来评估正中神经功能。
与对照组相比，患者沿正中神经的表观扩散系数（ADC）、轴向扩散率（AD）和径向扩散率（RD）降低（P < 0.001）。有神经内膜纤维化的患者ADC和RD降低最为明显。ADC和AD与神经传导速度呈正相关（分别为R = 0.54和R = 0.68），分数各向异性与力跟踪过程中的误差呈负相关（R = -0.58）。
在复发性CTS患者中识别出正中神经DTI变化的特定模式。纤维化可能是这些结构变化的基础。与神经传导速度和力控制准确性的相关性表明，DTI是研究复发性CTS正中神经结构的一种有前景的技术。
• 扩散张量成像（DTI）在肌肉骨骼磁共振成像中提供了更多可能性。• DTI揭示了复发性腕管综合征正中神经的变化。• 正中神经纤维化迹象时DTI变化更大。• DTI参数与神经传导和力控制测量相关。• DTI是复发性腕管综合征中有前景的技术。
