title: MR neurography of ulnar nerve entrapment at the cubital tunnel: a diffusion tensor imaging study.
abstract: OBJECTIVE
  MR neurography, diffusion tensor imaging (DTI) and tractography at 3 Tesla were evaluated for the assessment of patients with ulnar neuropathy at the elbow (UNE).
  
  
  METHODS
  Axial T2-weighted and single-shot DTI sequences (16 gradient encoding directions) were acquired, covering the cubital tunnel of 46 patients with clinically and electrodiagnostically confirmed UNE and 20 healthy controls. Cross-sectional area (CSA) was measured at the retrocondylar sulcus and FA and ADC values on each section along the ulnar nerve. Three-dimensional nerve tractography and T2-weighted neurography results were independently assessed by two raters.
  
  
  RESULTS
  Patients showed a significant reduction of ulnar nerve FA values at the retrocondylar sulcus (p = 0.002) and the deep flexor fascia (p = 0.005). At tractography, a complete or partial discontinuity of the ulnar nerve was found in 26/40 (65%) of patients. Assessment of T2 neurography was most sensitive in detecting UNE (sensitivity, 91%; specificity, 79%), followed by tractography (88%/69%). CSA and FA measurements were less effective in detecting UNE.
  
  
  CONCLUSIONS
  T2-weighted neurography remains the most sensitive MR technique in the imaging evaluation of clinically manifest UNE. DTI-based neurography at 3 Tesla supports the MR imaging assessment of UNE patients by adding quantitative and 3D imaging data.
  
  
  CONCLUSIONS
  • DTI and tractography support conventional MR neurography in the detection of UNE • Regionally reduced FA values and discontinuous tractography patterns indicate UNE • T2-weighted MR neurography remains the imaging gold standard in cases of UNE • DTI-based ulnar nerve tractography offers additional topographic information in 3D.
authors: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria, julia.breitenseher@meduniwien.ac.at.
authors: Julia B
authors: JB
authors: Breitenseher
authors: Gottfried
authors: G
authors: Kranz
authors: Alina
authors: A
authors: Hold
authors: Dominik
authors: D
authors: Berzaczy
authors: Stefan F
authors: SF
authors: Nemec
authors: Thomas
authors: T
authors: Sycha
authors: Michael
authors: M
authors: Weber
authors: Daniela
authors: D
authors: Prayer
authors: Gregor
authors: G
authors: Kasprian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056324:Diffusion Tensor Imaging / Q000379:methods*; D004551:Elbow Joint / Q000473:pathology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014459:Ulnar Nerve / Q000473:pathology; D017769:Ulnar Nerve Compression Syndromes / Q000175:diagnosis*