title: 3T diffusion tensor imaging and electroneurography of peripheral nerve: a morphofunctional analysis in carpal tunnel syndrome.
abstract: OBJECTIVE
  The aim of the study was to assess the diagnostic potential of diffusion tensor imaging (DTI) for pathologies of the peripheral nervous system (PNS) through clinical, electrophysiological and morphological evaluation of the median nerve.
  
  
  METHODS
  The present work was a multilevel prospective study involving 30 subjects, 15 of whom had carpal tunnel syndrome (CTS) and 15 healthy controls. All subjects underwent clinical evaluation through administration of the Boston Carpal Tunnel Questionnaire (BCTQ), electroneurography (ENG), 3-Tesla magnetic resonance imaging with DTI, and calculation of fractional anisotropy (FA) and the apparent diffusion coefficient (ADC) at the flexor retinaculum. Tractography was also performed for three-dimensional reconstruction of the route of the median nerve through the carpal tunnel. The degree of functional impairment was compared with the anatomical damage to the median nerve according to ENG and DTI.
  
  
  RESULTS
  FA and ADC were significantly correlated with ENG parameters of CTS and BCTQ data. Mean FA and ADC values in the CTS patients were 0.359±0.06 and 1.866±0.050×10(-3)mm(2)/s, respectively, vs 0.59±0.014 and 1.395±0.035×10(-3)mm(2)/s, respectively, in the controls. FA was decreased and ADC increased in patients with CTS compared with healthy controls (P<0.05).
  
  
  CONCLUSIONS
  DTI parameters were clearly confirmed by both clinical and ENG data and, therefore, may be used for the diagnosis of CTS.
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies Neurology section, "Sapienza" University of Rome, v.le dell'Università 30, 00185 Rome, Italy. Electronic address: marianna.brienza@gmail.com.
authors.forename: Marianna
authors.initials: M
authors.lastname: Brienza
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies Neurology section, "Sapienza" University of Rome, v.le dell'Università 30, 00185 Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pujia
authors.affiliation: Radiology DEA Department, Umberto I Hospital, "Sapienza" University of Rome, Rome, Italy.
authors.forename: M Chiara
authors.initials: MC
authors.lastname: Colaiacomo
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies Neurology section, "Sapienza" University of Rome, v.le dell'Università 30, 00185 Rome, Italy.
authors.forename: M Grazia
authors.initials: MG
authors.lastname: Anastasio
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies Neurology section, "Sapienza" University of Rome, v.le dell'Università 30, 00185 Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pierelli
authors.affiliation: Radiology DEA Department, Umberto I Hospital, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Di Biasi
authors.affiliation: Radiology DEA Department, Umberto I Hospital, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Andreoli
authors.affiliation: Radiology DEA Department, Umberto I Hospital, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Gualdi
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies Neurology section, "Sapienza" University of Rome, v.le dell'Università 30, 00185 Rome, Italy.
authors.forename: Gabriele O R
authors.initials: GO
authors.lastname: Valente
mesh_terms: D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000473:pathology* / Q000503:physiopathology*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D004568:Electrodiagnosis / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000473:pathology* / Q000503:physiopathology*; D008875:Middle Aged; D009431:Neural Conduction; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Apparent diffusion coefficient; Diffusion tensor imaging; Electroneurography; Fractional anisotropy; Median nerve