Combination of morphological and multiparametric MR neurography enhances carpal tunnel syndrome diagnosis and evaluation

Abstract This study aimed to investigate the diagnostic and evaluative significance of combining median nerve (MN) morphological measurements with diffusion tensor imaging (DTI) and T2 mapping metrics for carpal tunnel syndrome (CTS). Morphological and multiparametric magnetic resonance neurography...

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Main Authors: Youzhi Wang, Wenjun Wu, Jiamin Kang, Yu Su, Tingting Liu, Jie Zhao, Dingxi Liu, Xiangchuang Kong, Yuxiong Weng, Chuansheng Zheng, Chungao Li, Lixia Wang
Format: Article
Language:English
Published: Nature Portfolio 2025-01-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-84489-8
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author Youzhi Wang
Wenjun Wu
Jiamin Kang
Yu Su
Tingting Liu
Jie Zhao
Dingxi Liu
Xiangchuang Kong
Yuxiong Weng
Chuansheng Zheng
Chungao Li
Lixia Wang
author_facet Youzhi Wang
Wenjun Wu
Jiamin Kang
Yu Su
Tingting Liu
Jie Zhao
Dingxi Liu
Xiangchuang Kong
Yuxiong Weng
Chuansheng Zheng
Chungao Li
Lixia Wang
author_sort Youzhi Wang
collection DOAJ
description Abstract This study aimed to investigate the diagnostic and evaluative significance of combining median nerve (MN) morphological measurements with diffusion tensor imaging (DTI) and T2 mapping metrics for carpal tunnel syndrome (CTS). Morphological and multiparametric magnetic resonance neurography (MRN), along with clinical evaluation, were conducted on 33 CTS patients and 32 healthy controls. The MRN metrics included fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusivity (AD), radial diffusivity (RD), T2 value, cross-sectional area (CSA) and MN flattening ratio (MNFR) at both the pisiform bone and hamate bone levels. Differences in MRN metrics between the above two levels (Delta FA, Delta ADC, Delta AD, Delta RD and Delta T2) were calculated. T-tests, multivariable regression, and receiver operating characteristic (ROC) curve analyses were used to compare and classify patients with CTS and controls. The correlations between MRN metrics and clinical characteristics were analyzed. Comparisons were also made between MRN metrics in patients with and without significant symptom improvement after treatment. FA, AD, T2 value, and CSA at the pisiform bone level were identified as independent predictors of CTS. The combination of these metrics improved diagnostic performance (AUC 0.922, sensitivity 84.85% and specificity 90.62%). Delta ADC, Delta AD, and Delta T2 correlated with function Boston scores. The T2 value at hamate bone level, along with Delta AD and FA, correlated with visual analogue score (VAS). CSA and Delta T2 had higher AUCs for classifying patients with and without significant symptom improvement after treatment. These findings suggest that combining MN morphological and multiparametric MRN metrics can enhance the diagnostic performance of CTS and has the potential to provide an objective and quantitative basis for further study of the degree of entrapment and prognosis.
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spelling doaj-art-7731080db8ad4f748de530db47dd26ad2025-01-05T12:19:26ZengNature PortfolioScientific Reports2045-23222025-01-0115111210.1038/s41598-024-84489-8Combination of morphological and multiparametric MR neurography enhances carpal tunnel syndrome diagnosis and evaluationYouzhi Wang0Wenjun Wu1Jiamin Kang2Yu Su3Tingting Liu4Jie Zhao5Dingxi Liu6Xiangchuang Kong7Yuxiong Weng8Chuansheng Zheng9Chungao Li10Lixia Wang11Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract This study aimed to investigate the diagnostic and evaluative significance of combining median nerve (MN) morphological measurements with diffusion tensor imaging (DTI) and T2 mapping metrics for carpal tunnel syndrome (CTS). Morphological and multiparametric magnetic resonance neurography (MRN), along with clinical evaluation, were conducted on 33 CTS patients and 32 healthy controls. The MRN metrics included fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusivity (AD), radial diffusivity (RD), T2 value, cross-sectional area (CSA) and MN flattening ratio (MNFR) at both the pisiform bone and hamate bone levels. Differences in MRN metrics between the above two levels (Delta FA, Delta ADC, Delta AD, Delta RD and Delta T2) were calculated. T-tests, multivariable regression, and receiver operating characteristic (ROC) curve analyses were used to compare and classify patients with CTS and controls. The correlations between MRN metrics and clinical characteristics were analyzed. Comparisons were also made between MRN metrics in patients with and without significant symptom improvement after treatment. FA, AD, T2 value, and CSA at the pisiform bone level were identified as independent predictors of CTS. The combination of these metrics improved diagnostic performance (AUC 0.922, sensitivity 84.85% and specificity 90.62%). Delta ADC, Delta AD, and Delta T2 correlated with function Boston scores. The T2 value at hamate bone level, along with Delta AD and FA, correlated with visual analogue score (VAS). CSA and Delta T2 had higher AUCs for classifying patients with and without significant symptom improvement after treatment. These findings suggest that combining MN morphological and multiparametric MRN metrics can enhance the diagnostic performance of CTS and has the potential to provide an objective and quantitative basis for further study of the degree of entrapment and prognosis.https://doi.org/10.1038/s41598-024-84489-8Carpal tunnel syndromeMedian nerveDiffusion tensor imagingT2 mapping
spellingShingle Youzhi Wang
Wenjun Wu
Jiamin Kang
Yu Su
Tingting Liu
Jie Zhao
Dingxi Liu
Xiangchuang Kong
Yuxiong Weng
Chuansheng Zheng
Chungao Li
Lixia Wang
Combination of morphological and multiparametric MR neurography enhances carpal tunnel syndrome diagnosis and evaluation
Scientific Reports
Carpal tunnel syndrome
Median nerve
Diffusion tensor imaging
T2 mapping
title Combination of morphological and multiparametric MR neurography enhances carpal tunnel syndrome diagnosis and evaluation
title_full Combination of morphological and multiparametric MR neurography enhances carpal tunnel syndrome diagnosis and evaluation
title_fullStr Combination of morphological and multiparametric MR neurography enhances carpal tunnel syndrome diagnosis and evaluation
title_full_unstemmed Combination of morphological and multiparametric MR neurography enhances carpal tunnel syndrome diagnosis and evaluation
title_short Combination of morphological and multiparametric MR neurography enhances carpal tunnel syndrome diagnosis and evaluation
title_sort combination of morphological and multiparametric mr neurography enhances carpal tunnel syndrome diagnosis and evaluation
topic Carpal tunnel syndrome
Median nerve
Diffusion tensor imaging
T2 mapping
url https://doi.org/10.1038/s41598-024-84489-8
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