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- Title
MR neurography of ulnar nerve entrapment at the cubital tunnel: a diffusion tensor imaging study.
- Authors
Breitenseher, Julia; Kranz, Gottfried; Hold, Alina; Berzaczy, Dominik; Nemec, Stefan; Sycha, Thomas; Weber, Michael; Prayer, Daniela; Kasprian, Gregor
- Abstract
Objectives: 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. Conclusion: 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. Key Points: • 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
- Subjects
DIFFUSION tensor imaging; ULNAR neuropathies; ELECTRODIAGNOSIS; CUBITAL tunnel syndrome; MAGNETIC resonance neurography
- Publication
European Radiology, 2015, Vol 25, Issue 7, p1911
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-015-3613-7