Determination of optimum pixel size and slice thickness for tractography and ulnar nerve diffusion tensor imaging at the cubital tunnel using 3T MRI

Background Small peripheral nerve tractography is challenging because of the trade-off among resolution, image acquisition time, and signal-to-noise ratio. Purpose To optimize pixel size and slice thickness parameters for fiber tractography and diffusion tensor imaging (DTI) of the ulnar nerve at the cubital tunnel using 3T magnetic resonance imaging (MRI). Material and Methods Fifteen healthy volunteers (mean age 30 ± 6.8 years) were recruited prospectively. Axial T2-weighted and DTI scans were acquired, covering the cubital tunnel, using different pixel sizes and slice thicknesses. Three-dimensional (3D) nerve tractography was evaluated for the median number and length of the reconstructed fiber tracts and visual score from 0 to 5. Two-dimensional (2D) cross-sectional DTI was evaluated for fractional anisotropy (FA) values throughout the length of the ulnar nerve. Results A pixel size of 1.3 mm2 revealed the highest number of reconstructed nerve fibers compared to that of 1.1 mm2 ( P = 0.048), with a good visual score. A slice thickness of 4 mm had the highest number of reconstructed nerve fibers and visual score compared with other thicknesses (all P < 0.05). In 2D cross-sectional images, the median FA values were in the range of 0.40–0.63 at the proximal, central, and distal portions of the cubital tunnel. Inter-observer agreement for all parameters was good to excellent. Conclusion For fiber tractography and DTI of the ulnar nerve at the cubital tunnel, optimal image quality was obtained using a 1.3-mm2 pixel size and 4-mm slice thickness under MR parameters of this study at 3T.

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Role of diffusion tensor imaging in the evaluation of ulnar nerve involvement in leprosy

British Journal of Radiology ◽

10.1259/bjr.20210290 ◽

2021 ◽

pp. 20210290

Author(s):

Ankita Aggarwal ◽

Chandan Jyoti Das ◽

Neena Khanna ◽

Raju Sharma ◽

Deep Narayan Srivastava ◽

...

Keyword(s):

Diffusion Tensor Imaging ◽

Peripheral Neuropathy ◽

Ulnar Nerve ◽

Diffusion Tensor ◽

Cross Sectional Area ◽

Ulnar Neuropathy ◽

Control Group ◽

Sectional Area ◽

Cross Sectional

Objective: Early detection of peripheral neuropathy is extremely important as leprosy is one of the treatable causes of peripheral neuropathy. The study was undertaken to assess the role of diffusion tensor imaging (DTI) in ulnar neuropathy in leprosy patients. Methods: This was a case–control study including 38 patients (72 nerves) and 5 controls (10 nerves) done between January 2017 and June 2019. Skin biopsy proven cases of leprosy, having symptoms of ulnar neuropathy (proven on nerve conduction study) were included. MRI was performed on a 3 T MR system. Mean cross-sectional area, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of ulnar nerve at cubital tunnel were calculated. Additional ancillary findings and appearance of base sequences were evaluated. Results: Ulnar nerve showed thickening with altered T2W signal in all the affected nerves, having an average cross-sectional area of 0.26 cm2. Low FA with mean of 0.397 ± 0.19 and high ADC with mean of 1.28 ± 0.427 x 10 −3 mm2/s of ulnar nerve in retrocondylar groove was obtained. In the control group, mean cross-sectional area was 0.71cm2 with mean FA and ADC of 0.53 ± 0.088 and 1.03 ± 0.24 x 10 −3 mm2/s respectively. Statistically no significant difference was seen in diseased and control group. Cut-off to detect neuropathy for FA and ADC is 0.4835 and 1.1020 × 10 −3 mm2/s respectively. Conclusion: DTI though is challenging in peripheral nerves, however, is proving to be a powerful complementary tool for assessment of peripheral neuropathy. Our study validates its utility in infective neuropathies. Advances in knowledge: 1. DTI is a potential complementary tool for detection of peripheral neuropathies and can be incorporated in standard MR neurography protocol. 2. In leprosy-related ulnar neuropathy, altered signal intensity with thickening or abscess of the nerve is appreciated along with locoregional nodes and secondary denervation changes along with reduction of FA and rise in ADC value. 3. Best cut-offs obtained in our study for FA and ADC are 0.4835 and 1.1020 × 10 −3 mm2/s respectively.

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Diffusion tensor imaging in cubital tunnel syndrome

Scientific Reports ◽

10.1038/s41598-021-94211-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Timothy T. Griffiths ◽

Robert Flather ◽

Irvin Teh ◽

Hamied A. Haroon ◽

David Shelley ◽

...

Keyword(s):

Diffusion Tensor Imaging ◽

Fractional Anisotropy ◽

Ulnar Nerve ◽

Diffusion Tensor ◽

Cubital Tunnel Syndrome ◽

Mean Difference ◽

Cubital Tunnel ◽

Healthy Controls ◽

Radial Diffusivity ◽

Tunnel Syndrome

AbstractCubital tunnel syndrome (CuTS) is the 2nd most common compressive neuropathy. To improve both diagnosis and the selection of patients for surgery, there is a pressing need to develop a reliable and objective test of ulnar nerve ‘health’. Diffusion tensor imaging (DTI) characterises tissue microstructure and may identify differences in the normal ulnar from those affected by CuTS. The aim of this study was to compare the DTI metrics from the ulnar nerves of healthy (asymptomatic) adults and patients with CuTS awaiting surgery. DTI was acquired at 3.0 T using single-shot echo-planar imaging (55 axial slices, 3 mm thick, 1.5 mm2 in-plane) with 30 diffusion sensitising gradient directions, a b-value of 800 s/mm2 and 4 signal averages. The sequence was repeated with the phase-encoding direction reversed. Data were combined and corrected using the FMRIB Software Library (FSL) and reconstructed using generalized q-sampling imaging in DSI Studio. Throughout the length of the ulnar nerve, the fractional anisotropy (FA), quantitative anisotropy (QA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were extracted, then compared using mixed-effects linear regression. Thirteen healthy controls (8 males, 5 females) and 8 patients with CuTS (6 males, 2 females) completed the study. Throughout the length of the ulnar nerve, diffusion was more isotropic in patients with CuTS. Overall, patients with CuTS had a 6% lower FA than controls, with the largest difference observed proximal to the cubital tunnel (mean difference 0.087 [95% CI 0.035, 0.141]). Patients with CuTS also had a higher RD than controls, with the largest disparity observed within the forearm (mean difference 0.252 × 10–4 mm2/s [95% CI 0.085 × 10–4, 0.419 × 10–4]). There were no significant differences between patients and controls in QA, MD or AD. Throughout the length of the ulnar nerve, the fractional anisotropy and radial diffusivity in patients with CuTS are different to healthy controls. These findings suggest that DTI may provide an objective assessment of the ulnar nerve and potentially, improve the management of CuTS.

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MR neurography of ulnar nerve entrapment at the cubital tunnel: a diffusion tensor imaging study

European Radiology ◽

10.1007/s00330-015-3613-7 ◽

2015 ◽

Vol 25 (7) ◽

pp. 1911-1918 ◽

Cited By ~ 26

Author(s):

Julia B. Breitenseher ◽

Gottfried Kranz ◽

Alina Hold ◽

Dominik Berzaczy ◽

Stefan F. Nemec ◽

...

Keyword(s):

Diffusion Tensor Imaging ◽

Ulnar Nerve ◽

Diffusion Tensor ◽

Imaging Study ◽

Nerve Entrapment ◽

Cubital Tunnel ◽

Mr Neurography ◽

Ulnar Nerve Entrapment ◽

Diffusion Tensor Imaging Study

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Diagnosis of ulnar nerve entrapment anterior to the medial epicondyle by ultrasound elastography and diffusion tensor imaging with fiber tractography: a case report

Surgical and Radiologic Anatomy ◽

10.1007/s00276-021-02881-9 ◽

2022 ◽

Author(s):

Guillaume Jaques ◽

Fabio Becce ◽

Jean-Baptiste Ledoux ◽

Sébastien Durand

Keyword(s):

Diffusion Tensor Imaging ◽

Ulnar Nerve ◽

Diffusion Tensor ◽

Medial Epicondyle ◽

Nerve Entrapment ◽

Ultrasound Elastography ◽

Fiber Tractography ◽

Ulnar Nerve Entrapment ◽

Compressive Neuropathy ◽

And Diffusion

AbstractUlnar/cubital tunnel syndrome is the second most common compressive neuropathy of the upper limb. Permanent location of the ulnar nerve anterior to the medial epicondyle is extremely rare, with only five cases reported in the literature. Using ultrasound elastography and diffusion tensor imaging with fiber tractography, we diagnosed a case in which ulnar nerve entrapment was associated with anterior nerve location. Surgical release confirmed the diagnosis and the patient was symptom free 3 months after surgery.

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Evaluation of Brachial Plexus Using Combined Stereological Techniques of Diffusion Tensor Imaging and Fiber Tracking

Journal of Brachial Plexus and Peripheral Nerve Injury ◽

10.1055/s-0039-1687913 ◽

2019 ◽

Vol 14 (01) ◽

pp. e16-e23

Author(s):

Niyazi Acer ◽

Mehmet Turgut

Keyword(s):

Diffusion Tensor Imaging ◽

Brachial Plexus ◽

Diffusion Tensor ◽

Three Dimensional ◽

Fiber Tracking ◽

Nerve Fibers ◽

Fiber Tractography ◽

Functional Features

Background Brachial plexus (BP) is composed of intercommunications among the ventral roots of the nerves C5, C6, C7, C8, and T1 in the neck. The in vivo and in vitro evaluation of axons of the peripheral nervous system is performed using different techniques. Recently, many studies describing the application of fiber tractography and stereological axon number estimation to peripheral nerves have been published. Methods Various quantitative parameters of nerve fibers, including axon number, density, axonal area, and myelin thickness, can be estimated using stereological techniques. In vivo three-dimensional reconstruction of axons of BP can be visualized using a combined technique of diffusion tensor imaging (DTI) and fiber tracking with the potential to evaluate nerve fiber content. Conclusion It is concluded that terminal branches of BP can be successfully visualized using DTI, which is a highly reproducible method for the evaluation of BP as it shows anatomical and functional features of neural structures. We believe that quantitative morphological findings obtained from BP will be useful for new experimental, developmental, and pathological studies in the future.

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Meyer’s Loop Anatomy Demonstrated Using Diffusion Tensor MR Imaging and Fiber Tractography at 3T

Acta Medica Marisiensis ◽

10.2478/amma-2014-0045 ◽

2014 ◽

Vol 60 (5) ◽

pp. 215-222 ◽

Cited By ~ 1

Author(s):

Cristina Goga ◽

Zeynep Firat ◽

Klara Brinzaniuc ◽

Is Florian

Keyword(s):

Diffusion Tensor Imaging ◽

Diffusion Tensor ◽

Region Of Interest ◽

Fiber Tractography ◽

Brain Images ◽

3 Dimensional ◽

Software Release ◽

Magnetic Resonance Imaging Mri ◽

Meyer’S Loop

Abstract Objective: The ultimate anatomy of the Meyer’s loop continues to elude us. Diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) may be able to demonstrate, in vivo, the anatomy of the complex network of white matter fibers surrounding the Meyer’s loop and the optic radiations. This study aims at exploring the anatomy of the Meyer’s loop by using DTI and fiber tractography. Methods: Ten healthy subjects underwent magnetic resonance imaging (MRI) with DTI at 3 T. Using a region-of-interest (ROI) based diffusion tensor imaging and fiber tracking software (Release 2.6, Achieva, Philips), sequential ROI were placed to reconstruct visual fibers and neighboring projection fibers involved in the formation of Meyer’s loop. The 3-dimensional (3D) reconstructed fibers were visualized by superimposition on 3-planar MRI brain images to enhance their precise anatomical localization and relationship with other anatomical structures. Results: Several projection fiber including the optic radiation, occipitopontine/parietopontine fibers and posterior thalamic peduncle participated in the formation of Meyer’s loop. Two patterns of angulation of the Meyer’s loop were found. Conclusions: DTI with DTT provides a complimentary, in vivo, method to study the details of the anatomy of the Meyer’s loop.

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Diffusion tensor imaging and fiber tractography of the median nerve at 1.5T: optimization of b value

Skeletal Radiology ◽

10.1007/s00256-008-0577-6 ◽

2008 ◽

Vol 38 (1) ◽

pp. 51-59 ◽

Cited By ~ 38

Author(s):

Gustav Andreisek ◽

Lawrence M. White ◽

Andrea Kassner ◽

George Tomlinson ◽

Marshall S. Sussman

Keyword(s):

Diffusion Tensor Imaging ◽

Median Nerve ◽

Diffusion Tensor ◽

B Value ◽

Fiber Tractography

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Diffusion Tensor Imaging and Fiber Tractography in Children with Craniosynostosis Syndromes

American Journal of Neuroradiology ◽

10.3174/ajnr.a4301 ◽

2015 ◽

Vol 36 (8) ◽

pp. 1558-1564 ◽

Cited By ~ 6

Author(s):

B.F.M. Rijken ◽

A. Leemans ◽

Y. Lucas ◽

K. van Montfort ◽

I.M.J. Mathijssen ◽

...

Keyword(s):

Diffusion Tensor Imaging ◽

Diffusion Tensor ◽

Fiber Tractography

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Human Brain Diffusion Tensor Imaging Visualization With Virtual Reality

ASME 2010 World Conference on Innovative Virtual Reality ◽

10.1115/winvr2010-3761 ◽

2010 ◽

Author(s):

Bin Chen ◽

John Moreland

Keyword(s):

Virtual Reality ◽

Diffusion Tensor Imaging ◽

White Matter ◽

Diffusion Tensor ◽

Biological Tissues ◽

Head Tracking ◽

Fiber Tractography ◽

Brain White Matter ◽

Diffusion Tensors ◽

Visualization Techniques

Magnetic resonance diffusion tensor imaging (DTI) is sensitive to the anisotropic diffusion of water exerted by its macromolecular environment and has been shown useful in characterizing structures of ordered tissues such as the brain white matter, myocardium, and cartilage. The water diffusivity inside of biological tissues is characterized by the diffusion tensor, a rank-2 symmetrical 3×3 matrix, which consists of six independent variables. The diffusion tensor contains much information of diffusion anisotropy. However, it is difficult to perceive the characteristics of diffusion tensors by looking at the tensor elements even with the aid of traditional three dimensional visualization techniques. There is a need to fully explore the important characteristics of diffusion tensors in a straightforward and quantitative way. In this study, a virtual reality (VR) based MR DTI visualization with high resolution anatomical image segmentation and registration, ROI definition and neuronal white matter fiber tractography visualization and fMRI activation map integration is proposed. The VR application will utilize brain image visualization techniques including surface, volume, streamline and streamtube rendering, and use head tracking and wand for navigation and interaction, the application will allow the user to switch between different modalities and visualization techniques, as well making point and choose queries. The main purpose of the application is for basic research and clinical applications with quantitative and accurate measurements to depict the diffusivity or the degree of anisotropy derived from the diffusion tensor.

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