title: The diagnostic and grading value of diffusion tensor imaging in patients with carpal tunnel syndrome.
abstract: OBJECTIVE
  In this study, we investigated the diagnostic and grading value of diffusion tensor imaging (DTI) in patients with carpal tunnel syndrome (CTS).
  
  
  METHODS
  Of the 120 subjects included in the present study, 72 were in the CTS group and 48 were in the healthy control group. In addition, the patients with CTS were further divided into three subgroups based on severity (mild, moderate, and severe) according to electrophysiological studies (EPS). DTI-derived parameters (fractional anisotropy [FA] and apparent diffusion coefficient [ADC]) were evaluated at four median nerve levels. The mean FA and ADC values of the CTS groups and healthy controls were compared separately. Correlations and possible relationships between DTI parameters and EPS results were analyzed. Receiver operating characteristics analysis was used to calculate the FA and ADC cutoff values for CTS diagnosis and grading.
  
  
  RESULTS
  Statistically significant differences were observed in mean FA and ADC between the normal and mild, mild and moderate, and moderate and severe subgroups. Significant correlations were found between DTI parameters and EPS measurements based on severity. FA and ADC threshold values, as well as the sensitivity and specificity levels, for diagnosing and grading CTS were determined.
  
  
  CONCLUSIONS
  DTI parameters can provide helpful information for CTS. The correlations of FA and ADC measurements versus EPS measurements based on severity were significant. Moreover, FA and ADC threshold values were sufficient for the diagnosis and grading of CTS.
authors.affiliation: Department of Radiology, Medical Faculty of Adiyaman University, Adiyaman, 02100 Turkey. Electronic address: taner.bulut02@gmail.com.
authors.forename: Haci Taner
authors.initials: HT
authors.lastname: Bulut
authors.affiliation: Department of Physical Medicine and Rehabilitation, Medical Faculty of Adiyaman University, Adiyaman, 02100 Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Yildirim
authors.affiliation: Department of Neurology, Medical Faculty of Adiyaman University, Adiyaman, 02100 Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Ekmekci
authors.affiliation: Department of Radiology, Samsun Education and Research Hospital, Samsun, Turkey.
authors.forename: Hediye Pinar
authors.initials: HP
authors.lastname: Gunbey
mesh_terms: D000328:Adult; D016880:Anisotropy; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D017352:Echo-Planar Imaging / Q000379:methods*; D055724:Electrophysiological Phenomena / Q000502:physiology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
keywords: Carpal tunnel syndrome; diffusion tensor imaging; electrophysiological studies; median nerve