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Abstract The aim of this study is is to assess the ability of diffusion tensor imaging in diagnosis of CTS especially mild and moderate cases and to correlate FA and ADC with nerve conduction study and clinical tests Carpal tunnel syndrome (CTS) is caused by an entrapment of the median nerve at the level of the carpal tunnel. The CTS is a common disorder with an estimate 6% annual of adults in the general population incidence rate. Early treatment is impor¬tant to avoid permanent damage to the median nerve. Patients with mild disease treated with six weeks to three months of conservative treatment and patients with mod¬erate disease, referred for surgical evaluation Diagnosis of CTS is usually established by characteristic clinical features, clinical tests and nerve conduction studies. But, there is overlap and false results with clinical tests and nerve conduction studies Ultrasound has been used for diagnosis of CTS, but their results are conflicting and operator dependent Routine magnetic resonance imaging used for assessment of CTS but its results is in qualitative and variable Diffusion weighted MR imaging and diffusion tensor imaging allows for measurement of the tissue microstructure and reflects the random motion of water protons Diffusion tensor imaging extracts and characterizes diffusion patterns to provide exquisite details of tissue microstructure and fiber tracking. The 2 most common mea¬sures of the diffusion tensor are the trace and anisotropy. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) are widely used in diffusion tensor imaging to measure compactness of the tissues and inter¬cellular space and provide estimates independent of fiber di¬rectionality. The FA estimates the coherence of oriented structures such as myelinated nerve fi¬bers. Water within a voxel diffuses preferentially along one axis rather than exhibiting isotropic dif¬fusion to the extent. Diffusion tensor imaging is used for imaging of peripheral nerves in different parts of the body. Few studies discuss the role of diffusion tensor imaging of CTS This study was carried out on 40 patients (30 females and 10males) suffering from idiopathic CTS attending the Outpatient Clinic in the Physical Medicine, Rheumatology and Rehabilitation Departments, Mansoura University Hospital and 20 healthy controls of matched age and sex. There was statistically significant difference in FA and ADC of the median nerve between patients and volunteers. |