MUSCULOSKELETAL RADIOLOGY / ORIGINAL PAPER
An observational pilot study comparing diffusion tensor neurography findings of the median nerve in carpal tunnel syndrome patients and healthy controls
1
Department of Radiodiagnosis, All India Institute of Medical Sciences (AIIMS), Patna, India
Submission date: 2025-03-26
Acceptance date: 2025-12-15
Publication date: 2026-09-04
Corresponding author
Sreehari C.S.
Department of Radiodiagnosis, All India Institute of Medical Sciences (AIIMS), AIIMS Patna, Phulwari Sharif, Bihar, India, PIN: 801507
Department of Radiodiagnosis, All India Institute of Medical Sciences (AIIMS), AIIMS Patna, Phulwari Sharif, Bihar, India, PIN: 801507
Pol J Radiol, 2026; 91(1): 421-428
KEYWORDS
TOPICS
ABSTRACT
Purpose:
To determine normative fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the median nerve in the healthy population across various age groups and genders and to derive cut-off FA and ADC values for diagnosing carpal tunnel syndrome (CTS).
Material and methods:
After ethics board approval and written informed consent were obtained, 60 healthy volunteers (42 women, 18 men) and 20 patients (14 women, 6 men) were studied. Magnetic resonance (MR) neurography with diffusion-tensor imaging (DTI) was performed in all study participants at 3.0 T by using a single-shot echo-planar imaging sequence (repetition time msec/echo time msec, 10,123/40; b-value, 1000 sec/mm2). FA and ADC of the median nerve were determined at 3 locations: the levels of the distal radioulnar joint, pisiform bone, and hamate bone.
Results:
Normative FA and ADC values were calculated at different anatomic locations. FA and ADC did not differ between men and women (p = 0.46 and p = 0.41, respectively) or age dependence. There was significant difference between healthy volunteers and patients with carpal tunnel syndrome (p = 0.001 for both FA and ADC). An FA threshold of 0.545 and an ADC threshold of 0.822 × 10–3 mm2/sec might be used in the diagnosis of carpal tunnel syndrome. Cross sectional area threshold of 10.8 mm2 at the carpal tunnel (inlet) was also noted for diagnosis of carpal tunnel syndrome.
Conclusions:
DTI is a valuable tool in diagnosing CTS. Patients with CTS demonstrate lower FA and higher ADC values. FA and ADC threshold values might be used to diagnose carpal tunnel syndrome.
To determine normative fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the median nerve in the healthy population across various age groups and genders and to derive cut-off FA and ADC values for diagnosing carpal tunnel syndrome (CTS).
Material and methods:
After ethics board approval and written informed consent were obtained, 60 healthy volunteers (42 women, 18 men) and 20 patients (14 women, 6 men) were studied. Magnetic resonance (MR) neurography with diffusion-tensor imaging (DTI) was performed in all study participants at 3.0 T by using a single-shot echo-planar imaging sequence (repetition time msec/echo time msec, 10,123/40; b-value, 1000 sec/mm2). FA and ADC of the median nerve were determined at 3 locations: the levels of the distal radioulnar joint, pisiform bone, and hamate bone.
Results:
Normative FA and ADC values were calculated at different anatomic locations. FA and ADC did not differ between men and women (p = 0.46 and p = 0.41, respectively) or age dependence. There was significant difference between healthy volunteers and patients with carpal tunnel syndrome (p = 0.001 for both FA and ADC). An FA threshold of 0.545 and an ADC threshold of 0.822 × 10–3 mm2/sec might be used in the diagnosis of carpal tunnel syndrome. Cross sectional area threshold of 10.8 mm2 at the carpal tunnel (inlet) was also noted for diagnosis of carpal tunnel syndrome.
Conclusions:
DTI is a valuable tool in diagnosing CTS. Patients with CTS demonstrate lower FA and higher ADC values. FA and ADC threshold values might be used to diagnose carpal tunnel syndrome.
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