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Updated: Apr 12, 2026
Screening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies
Published on: January 11, 2019
Optimal parameters and location for diffusion-tensor imaging in the diagnosis of carpal tunnel syndrome: a
Bong Cheol Kwon1, Sung Hye Koh, Su Yeon Hwang
11 Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 896 Pyeongchondong, Dongangu, Anyang, Kyeonggido 431-070, South Korea.
Objective:
The purpose of this study was to determine the optimal parameters and location for diffusion-tensor imaging in the diagnosis of carpal tunnel syndrome.
Subjects And Methods:
A single 3-T MRI (single-shot echo-planar imaging pulse sequence; b value, 1000 s/mm(2)) and nerve conduction study were performed prospectively for patients with carpal tunnel syndrome and age- and sex-matched control subjects. Fractional anisotropy, apparent diffusion coefficient, radial diffusivity, and parallel diffusivity of the median nerve were measured at the inlet, middle, and outlet of the carpal tunnel and were compared with the nerve conduction study parameters.
Results:
A total of 50 patients with carpal tunnel syndrome and 50 control subjects were enrolled. Demographic data were comparable between the groups. For all three locations, mean fractional anisotropy increased significantly, and the mean radial diffusivity and apparent diffusion coefficient decreased significantly in carpal tunnel syndrome (p < 0.05). The carpal tunnel inlet had the largest and most consistent changes in diffusion-tensor imaging parameters. Fractional anisotropy measured at the carpal tunnel inlet had the highest diagnostic accuracy, as measured with ROC curves (AUC, 0.82). For a fractional anisotropy threshold of 0.44 or less at the carpal tunnel inlet, sensitivity was 72%; specificity, 82%; positive predictive value, 80%; and negative predictive value, 75%.
Conclusion:
The use of fractional anisotropy measured at the carpal tunnel inlet is optimal for diagnosing carpal tunnel syndrome.
