Diffusion Tensor Imaging In Patients Research Articles

Thalamic segmentation based on diffusion tensor imaging in patients with trigeminal neuralgia

Classical trigeminal neuralgia (CTN) refers to episodic pain that is strictly confined to the trigeminal distribution area, and the thalamus is an important component of the trigeminal sensory pathway. Probabilistic tracking imaging algorithm was used to identify specific connections between the thalamus and the cortex, in order to identify structural changes in the thalamus of patients with CTN and perform thalamic segmentation. A total of 32 patients with CTN and 32 healthy controls underwent DTI-MRI scanning (3.0 T). Differences in fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) between the groups were studied. Correlation analysis was performed with clinical course and pain level. Compared to the healthy controls, patients in the CTN group had significantly reduced FA, increased AD, RD and MD in somatosensory subregion of the bilateral thalamus, increased RD in frontal subregion, increased RD and MD in motor subregion. Correlation analysis showed that patient history was positively correlated with pain grading, and that medical history was positively correlated with significantly reduced FA in somatosensory subregion, negatively correlated with increased RD and MD in motor subregion. We used DTI-based probabilistic fiber tracking to discover altered structural connectivity between the thalamus and cerebral cortex in patients with CTN and to obtain a thalamic segmentation atlas, which will help to further understand the pathophysiology of CTN and serve as a future reference for thalamic deep brain stimulation electrode implantation for the treatment of intractable pain.

Clinical utility of abbreviated breast MRI based on diffusion tensor imaging in patients underwent breast conservative therapy.

To evaluate the added value of the diffusion tensor imaging (DTI) parameters to abbreviated breast MRI protocol in differentiating recurrent breast cancer from post-operative changes in cases of breast conservative surgery (BCS). This prospective study was approved by our institutional review board. Written informed consent was obtained in all patients. 47 female patients (mean age, 49years; range, 32-66years) that previously underwent breast conservative surgery with a palpable mass were included in this study (62 breast lesions). Two abbreviated MRI protocols were compared using 1.5 Tesla MRI, AB-MRI 1 (axial T1, T2, pre-contrast T1, 1st post-contrast and subtracted images) and AB-MRI 2 (same sequences plus adding DTI). In both protocols, the wash-in rate was calculated. Histopathology was used as the standard of reference. Appropriate statistical tests were used to assess sensitivity, specificity, and diagnostic accuracy for each protocol. The mean total acquisition time was of 6min for AB-MRI 1 and 10min for AB-MRI 2 protocols while the mean interpretation time was of 57.5 and 75s, respectively. Among analyzed DTI parameters, MD (mean diffusivity) showed the highest sensitivity (96.43%) and specificity (91.18%) (P value = < 0.001). FA (fractional anisotropy), AD (axial diffusivity) and RD (radial diffusivity) showed sensitivity = (78.57%, 82.14% and 85.71%), specificity = (88.24, 85.29% and 79.41%), respectively, P value (< 0.001). DTI may be included in abbreviated MRI protocols without a significant increase in acquisition time and with the advantage of increasing specificity and clinical utility in the characterization of post-conservative breast lesions.

Cortical thickness and diffusion tensor imaging in patients with neuropsychiatric systemic lupus erythematosus, with normal structure on brain MRI.

Neuropsychiatric systemic lupus erythematosus (NPSLE) is associated with adverse outcomes; however, imaging abnormalities are only detectable by conventional brain magnetic resonance imaging (MRI) in up to 50% of patients. This study investigated the variability in cortical thickness and diffusion tensor imaging (DTI) parameters among patients with NPSLE whose brain morphology appeared normal on conventional MRI. This retrospective study enrolled 27 female patients with NPSLE (median age: 41.0 years, range: 22-63years) and 34 female healthy controls (median age: 37.0years, range: 24-55years). None exhibited evident abnormalities on conventional MRI. Regional volumes, cortical thickness, and DTI parameters, including fractional anisotropy (FA) and mean diffusivity (MD), were compared. Age-adjusted multivariable logistic regression analysis was conducted to detect significant NPSLE-associated differences. No significant differences in grey or white matter volume fractions were observed between the groups. However, the NPSLE group demonstrated significant cortical thinning in the right pars opercularis (2.45 vs 2.52mm, p = 0.007), reduced FA values in the fornix (0.35 vs 0.40, p = 0.001) and left anterior limb of internal capsule (0.50 vs 0.52, p = 0.012), and increased MD in the fornix (1.71 vs 1.48, p = 0.009) and left posterior corona radiata (0.80 vs 0.76, p = 0.005) compared with those of healthy controls. Cortical thickness measurements and DTI analyses can be used to detect differential variations in patients with NPSLE who exhibit an otherwise normal brain structure on conventional MRI, indicating the existence of subtle changes despite the absence of obvious macrostructural central nervous system involvement of lupus.

Glymphatic system evaluation using diffusion tensor imaging in patients with traumatic brain injury.

Glymphatic system dysfunction has been reported in animal models of traumatic brain injury (TBI). This study aimed to evaluate the activity of the human glymphatic system using the non-invasive Diffusion Tensor Image-Analysis aLong the Perivascular Space (DTI-ALPS) method in patients with TBI. A total of 89 patients with TBI (June 2018 to May 2020) were retrospectively enrolled, and 34 healthy volunteers were included who had no previous medical or neurological disease. Magnetic resonance imaging (MRI) with DTI was performed, and the ALPS index was calculated to evaluate the glymphatic system's activity. Wilcoxon rank-sum test was used to compare the ALPS index between patients with TBI and healthy controls. ANOVA was done to compare the ALPS index among controls and patients with mild/moderate-to-severe TBI. Multivariate logistic regression analyses were used to identify independent clinical and radiological factors associated with the ALPS index. The correlation between Glasgow Coma Scale (GCS) score and the ALPS index was also assessed. The ALPS index was significantly lower in patients with TBI than in healthy controls (median, 1.317 vs. 1.456, P < 0.0001). There were significant differences in the ALPS index between healthy controls and patients with mild/moderate-to-severe TBI (ANOVA, P < 0.001). The presence of subarachnoid hemorrhage (P = 0.004) and diffuse axonal injury (P = 0.001) was correlated with a lower ALPS index in the multivariate analysis. There was a weak positive correlation between the ALPS index and GCS scores (r = 0.242, P = 0.023). The DTI-ALPS method is useful for evaluating glymphatic system impairment and quantifying its activity in patients with TBI.

Diagnostic value of diffusion tensor imaging in patients with clinical signs of cervical spondylotic myelopathy.

The aim of this study was to assess the diagnostic value of diffusion tensor imaging (DTI) in patients with symptoms of cervical myelopathy. Detailed goals included determining the diagnostic effectiveness of quantitative parameters, i.e. fractional anisotropy (FA) and apparent diffusion coefficient (ADC), in the diagnosis of cervical myelopathy, and the correlation between these parameters and clinical symptoms. The demonstration of an ischaemic focus in the spinal cord by standard magnetic resonance imaging (MRI) methods is associated with already accomplished spinal cord damage, and of course limited treatment options. Therefore, finding a new examination protocol that allows early diagnosis of myelopathic focus, before the onset of full neurological symptoms, has become a priority in the diagnosis and treatment of spine diseases. Such an examination increases the chances of correctly qualifying the patient for conservative vs. surgical treatment. Between 2013 and 2017, 128 adults with clinical signs of cervical myelopathy were examined, and were divided into four symptomatic subgroups. A control group consisted of 37 healthy volunteers. DTI values were measured at the level of C2/C3, and at the most severe stenosis of the spine. In patients with cervical spondylotic myelopathy (CSM), the ADC values were significantly higher (p < 0.001), and FA values were significantly lower (p < 0.001), than in healthy volunteers at the stenotic level. There were significant differences in DTI parameters between the clinical subgroups (p < 0.001). Changes in DTI parameters indicate a microstructural disorder of the core which is not visible in a structural MRI. FA and ADC values measured at the level of the most severe stenosis of the spinal canal allow the differentiation of patients with myelopathy of varying degrees of clinical severity. Extending standard MRI to include assessment of FA and ADC may be helpful in deciding treatment modalities (conservative vs. surgical) for patients with visible canal stenosis without full neurological symptoms. This may be useful in selecting patients for urgent rehabilitative treatment. This study is a starting point for further research, i.e. an evaluation of the extent of FA and ADC lesion withdrawal after surgical treatment.

Comparison of region-of-interest delineation methods for diffusion tensor imaging in patients with cervical spondylotic radiculopathy

BackgroundDiffusion tensor imaging is a promising technique for determining the responsible lesion of cervical radiculopathy, but the selection and delineation of the region of interest (ROI) affect the results. This study explored the impact of different ROI sketching methods on the repeatability and consistency of DTI measurement values in patients with cervical spondylotic radiculopathy (CSR).MethodsThis retrospective study included CSR patients who underwent DTI imaging. The images were analyzed independently by two radiologists. Four delineation methods were used: freehand method, maximum roundness, quadrilateral method, and multi-point averaging method. They re-examined the images 6 weeks later. The intra-class correlation coefficient (ICC) was used to investigate the consistency between the two measurements and the reproducibility between two radiologists.ResultsForty-two CSR patients were included in this study. The distribution of the compressed nerve roots was five C4, eight C5, sixteen C6, eleven C7, and two C8. No differences were found among the four methods in fractional anisotropy (FA) or apparent diffusion coefficient (ADC), irrespective of radiologists (all P>0.05). Similar results were observed between the first and second measurements (all P>0.05), but some significant differences were observed for radiologist 2 for the four-small rounds method (P=0.033). The freehand and single largest circle methods were the two methods with the highest ICC between the two measurements and the two radiologists (all ICC >0.90).ConclusionThe freehand and single largest circle methods were the most consistent methods for delineating DTI ROI in patients with CSR.

Altered Thalamic Connectivity Due to Focused Ultrasound Thalamotomy in Patients with Essential Tremor

Although stereotactic ablation surgery is known to ameliorate involuntary movement dramatically, little is known regarding alterations in whole-brain networks due to disruption of the deep brain nucleus. To explore changes in the whole-brain network after thalamotomy, we analyzed structural and functional connectivity alterations using resting-state functional magnetic resonance imaging and diffusion tensor imaging in patients with essential tremor who had undergone focused ultrasound (FUS) thalamotomy. Seven patients with intractable essential tremors and 7 age-matched healthy controls were enrolled in the study. The tremor score in essential tremor patients was assessed, and resting-state functional magnetic resonance imaging and diffusion tensor imaging were performed before and 3months after left ventral intermediate nucleus thalamotomy using FUS. There was a significant improvement in the tremor of the right hand after FUS thalamotomy. Seed-based functional connectivity analysis revealed a significant increase in functional connectivity between the left thalamus and the caudal part of the dorsal premotor cortex after FUS thalamotomy. Structural connectivity analysis did not detect statistically significant changes between before and after FUS. There was no correlation between the changes in functional connectivity and tremor score. Although the number of cases is small, our results show that functional connectivity between the thalamus and the premotor cortex increases after the amelioration of tremors by FUS thalamotomy. The lack of correlation between increased functional connectivity and clinical tremor scores suggests that the observed increase in functional connectivity may be a compensatory change in the secondary sensorimotor changes that occur after thalamotomy.

A study on diffusion tensor imaging in patients with untreated first-episode obsessive-compulsive disorder.

The present study provides an overview of studies investigating white matter (WM) integrity in patients with obsessive-compulsive disorder (OCD) using diffusion tensor imaging (DTI). Furthermore, it studies the correlation of fractional anisotropy (FA) in abnormal cerebral WM areas with the course and clinical signs of the disease. The study subjects were divided into two groups, the OCD group (n=38) and the control group (n=40), based on the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) diagnostic criteria for OCD. Patients with untreated first-episode OCD were assigned to the OCD group, while healthy volunteers were assigned to the control group. The study group was evaluated in accordance with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS). Subjects who met the inclusion criteria underwent whole-brain scanning via 3.0 T structural magnetic resonance imaging (sMRI). The WM FA values in different brain areas were compared between the two groups using voxel-based analysis (VBA). Subsequently, the correlations of the patient Y-BOCS score and disorder course with the FA values in significantly improved encephalic areas were analyzed. (I) The FA values of the right precentral gyrus (PreCG.R), left insular lobe, left inferior frontal gyrus and right inferior occipital gyrus (Occipital_Inf_R) WM were significantly lower in the OCD group than in the control group (P<0.05). Elevated FA values were not observed in the OCD group. (II) FA values of PreCG.R, left insular lobe/left inferior frontal gyrus, and Occipital_Inf_R were not found in relation to the total Y-BOCS score (P=0.122; P=0.401; P=0.134), obsessional thoughts score (P=0.299; P=0.760; P=0.062), compulsive activities checklist (P=0.487; P=0.420; P=0.431), and disease course (P=0.604; P=0.380; P=0.182). Multiple microstructural cerebral WM changes were observed in the frontal lobe, occipital lobe, and insula in patients with untreated first-episode OCD, presenting the correlation of these changes with OCD occurrence.

Clinical Profile and Diffusion Tensor Imaging in Patients of Subacute Sclerosing Pan Encephalitis: A Prospective Follow-up Study from Eastern Part of India.

Subacute Sclerosing Pan Encephalitis (SSPE) may present with atypical clinical features and lead to diagnostic dilemma. Conventional magnetic resonance imaging (MRI) may be normal in early stage of SSPE. The aim of this work was to study the demography, clinical profile including atypical features of SSPE patients, and the utility of diffusion tensor imaging (DTI) as an adjunctive diagnostic tool to the anti-measles antibody and conventional MRI. Consecutive 25 patients of SSPE were included. Clinical details were recorded at baseline and 6 months follow-up. Anti-measles antibody in serum and CSF, CSF/Serum Quotient reference (CSQ ref), and radiological details including comparison of DTI between SSPE patients and controls were also noted. Of 25 patients, 17 (68%) were male. The most common presenting feature at onset was myoclonus with or without falls (13, 52%). Atypical features such as seizure, hemiparesis, and visual problems were present in 28% patients. At 6 months, 9 patients had progressive course (6 expired), 10 were static, and 6 lost to follow-up. MRI was normal in 8 (32%) patients (stage 2/3- 7/1). On comparison between SSPE patients (N = 10) and control (N = 10) groups, fractional anisotropy (FA), and apparent diffusion coefficient (ADC) values were reduced and elevated, respectively, at most of the regions of interest with significant difference at many sites. A significant number of patients (28%) had atypical features at onset. DTI is an adjunctive tool which supplements the conventional MRI and increase diagnostic yield. It may be a future option to assess disease progression and treatment response.

Evaluation of Optical Radiation from Visual Pathways with Diffusion Tensor Imaging in Patients with Neurofibromatosis Type 1

Evaluation of Optical Radiation from Visual Pathways with Diffusion Tensor Imaging in Patients with Neurofibromatosis Type 1

Analysis of the Effect of Magnetic Resonance Diffusion Tensor Imaging in Patients with Stuttering

Purpose — To discuss the applying effectiveness analysis of magnetic resonance diffusion tensor imaging among stuttering patients. Method — Choose 81 suspected stuttering patients between May, 2018 to May, 2021 as researching objects. All of the patients did the test of magnetic resonance diffusion tensor imaging. And then the testing results was compared with clinical examination results (Gold standard), ROC curve was drawn to analyze the applying effectiveness analysis of magnetic resonance diffusion tensor imaging among stuttering patients. Results — 70 patients were diagnosed as stuttering patients from clinical examination among the 81 suspected stuttering patients. The diagnosis rate is 86.42%. After all of the patients did the test of magnetic resonance diffusion tensor imaging, 68 patients were diagnosed as stuttering patients finally. Diagnosis coincidence rate is 97.14% (P&gt;0.05). The rFA levels of the insula, corpus callosum, and putamen on the side of stuttering lesion are lower than those on the healthy side (P&lt;0.05). The rFA of the cerebrum, internal capsule, and cerebellum on the lesion side and the contralateral side has no statistical significance (P&gt;0.05). The ROC curve shows that the AUC data of magnetic resonance diffusion tensor imaging in stuttering patients is 0.834, the diagnostic sensitivity is 84.31%, and the specificity is 71.48%. Conclusion — Magnetic resonance diffusion tensor imaging applying in stuttering patients can gain higher detection rate, which can provide imaging evidence for clinical diagnosis and treatment for clinical and is worthy to promoting and applying.

The Functional Relevance of Diffusion Tensor Imaging in Patients with Degenerative Cervical Myelopathy.

(1) Background: In addition to conventional magnetic resonance imaging (MRI), diffusion tensor imaging (DTI) has been investigated as a potential diagnostic and predictive tool for patients with degenerative cervical myelopathy (DCM). In this preliminary study, we evaluated the use of quantitative DTI in the clinical practice as a possible measure to correlate with upper limbs function. (2) Methods: A total of 11 patients were enrolled in this prospective observational study. Fractional anisotropy (FA) values was extracted from DTI data before and after surgery using a GE Signa 1.5 T MRI scanner. The Nine-Hole Peg Test and a digital dynamometer were used to measure dexterity and hand strength, respectively. (3) Results: We found a significant increase of FA values after surgery, in particular below the most compressed level (p = 0.044) as well as an improvement in postoperative dexterity and hand strength. Postoperative FA values moderately correlate with hand dexterity (r = 0.4272, R2 = 0.0735, p = 0.19 for the right hand; r = 0.2087, R2 = 0.2265, p = 0.53 for the left hand). (4) Conclusion: FA may be used as a marker of myelopathy and could represent a promising diagnostic value in patients affected by DCM. Surgical decompression can improve the clinical outcome of these patients, especially in terms of the control of finger-hand coordination and dexterity.

Assessment of Auditory Pathways Using Diffusion Tensor Imaging in Patients with Neurofibromatosis Type 1.

Aim:The aim of our study was to determine whether the diffusion properties of the auditory pathways alter between patients with Neurofibromatosis type 1 (NF1) and the healthy subjects. DTI can well demonstrate FA and ADC changes in auditory tracts and it may be a guide to identify the candidates for hearing loss among NF1 children.Methods:The study population consisted of 43 patients with NF1 and 21 healthy controls. Diffusion tensor imaging (DTI) was used to measure apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values from lemniscus lateralis, colliculus inferior, corpus geniculatum mediale and Heschl's gyrus. The results were compared with those of the control group.Results:The ADC values of lateral lemniscus, colliculus inferior and corpus geniculatum mediale were significantly higher in NF1 compared to those of the control group. On the other hand, decreased FA values were observed in lateral lemniscus and colliculus inferior in patients with NF1.Conclusion:The increase in ADC and reduction in FA in the auditory pathways of patients with NF1 may suggest microstructural alterations, such as a decrease in the number of axons, edema or inflammation in the auditory tracts.

Diffusion Tensor Imaging in Patients Undergoing Re-Irradiation for Progressive DIPG

Diffusion Tensor Imaging in Patients Undergoing Re-Irradiation for Progressive DIPG

Longitudinal diffusion tensor imaging of patients with degenerative cervical myelopathy following decompression surgery

Previous studies have reported the utility of diffusion tensor imaging (DTI) as an imaging biomarker for the severity of myelopathy and subsequent surgical outcome in patients with degenerative cervical myelopathy (DCM). We hypothesized that DTI may reflect neurological recovery following surgery. The purpose of this study was to evaluate the ability of DTI to assess the post-operative alteration of neural status in patients with DCM as well as to predict post-operative recovery. We enrolled 15 patients with DCM who underwent decompression surgery. The Japanese Orthopaedic Association (JOA) score was evaluated before and 1 year after surgery. The participants were examined using DTI on a 3.0 T magnetic resonance scanner before, and 1 year after surgery. Fractional anisotropy (FA) and mean diffusivity (MD) were assessed for both time points. The correlations between the pre- and post-operative FA and MD values and the pre- and post-operative JOA scores were analyzed. Although the JOA score improved significantly after surgery from 8.9 to 12.3, there was no significant change between the pre- and post-operative FA and MD values. The post-operative outcomes after 1 year moderately correlated with the pre-operative FA values (Spearman’s ρ = 0.55, p = 0.03 and Spearman’s ρ = 0.56, p = 0.03 for change and recovery rate of the JOA score, respectively). However, there was no correlation between the post-operative FA and post-operative JOA scores nor between MD and clinical outcomes. DTI cannot be utilized as a biomarker for post-operative alterations of neural status of the spinal cord; however, pre-operative DTI may be useful as a predictor of surgical outcomes.

Microstructural white matter changes using diffusion tensor imaging in patients with Cushing's disease

Microstructural white matter changes using diffusion tensor imaging in patients with Cushing's disease

Prognostic Value of Craniovertebral Junction Diffusion Tensor Imaging in Patients with Chiari Type 1 Malformation.

To examine the spinal cord status by using diffusion tensor imagıng (DTI) and tractography preoperatively and postoperatively in patients with Chiari malformation type 1 (CM1) and compare the results with the data obtained from healthy people. Overall, 48 patients (33 patients with CM1, and 15 in the control group for DTI and tractography measurements) were included in the study. Mean age was 37.7 ± 11.8 years (minimum and maximum: 12 and 57 years). The DTI and tractography data were obtained from the craniocervical region in patients with CM1 and control group. Patients with CM1 were operated using the suboccipital decompression technique without opening the dura. Surgical results were evaluated using Chicago Chiari Outcome Scale (CCOS) and Asgari scale. Based on the CCOS and Asgari scale results, the surgical technique was determined to be clinically beneficial. The DTI and tractography values from the pontobulbar, cervicomedullary, and spinal cord C3â€"4 levels in patients with CM1 were compared to those of the control group. These values were observed to be near normal after surgery in patients with CM1. Based on the improvement in DTI-tractography data observed in our study, DTI and tractography can serve as a guiding measurement method for assessing the prognosis of patients with CM1.

Diffusion tensor imaging in patients with disorders of consciousness

Diffusion tensor imaging in patients with disorders of consciousness

Renal fat fraction and diffusion tensor imaging in patients with early-stage diabetic nephropathy.

To investigate the renal fat fraction and water molecular diffusion features in patients with early-stage DN using Dixon imaging and diffusion tensor imaging (DTI). Sixty-one type 2 diabetics (normoalbuminuria: n = 40; microalbuminuria: n = 21) and 34 non-diabetic volunteers were included. All participants received three-point Dixon imaging and DTI using a 3.0-T magnetic resonance imager. The fat fraction [FF] and DTI features [fractional anisotropy (FA), apparent diffusion coefficient (ADC), tract counts and length from DTI tractography] were collected. All image features were compared between cohorts using one-way ANOVA with Bonferroni post-hoc analysis. Renal FF in the microalbuminuric group was significantly higher than in the normoalbuminuric and control groups (5.6% ± 1.3%, 4.7% ± 1.1% and 4.3% ± 0.5%, respectively; p < 0.001). Medullary FA in the microalbuminuric group was the lowest (0.31 ± 0.06) in all cohorts. The tract counts and length in the renal medulla were significantly lower in the microalbuminuric group than in the other two groups. Dixon imaging and DTI are able to detect renal lipid deposition and water molecule diffusion abnormalities in patients with early-stage DN. Both techniques have the potential to noninvasively evaluate early renal impairment in type 2 diabetes. • Dixon imaging demonstrated renal fat deposition in early-stage DN; • Renal fractional anisotropy decreased in patients with early-stage DN; • Renal tractography demonstrated reduced track counts and length in early-stage DN.

Evaluation of median nerve by shear wave elastography and diffusion tensor imaging in carpal tunnel syndrome

PurposeThe aim of the current study is to investigate the diagnostic role of shear-wave elastography and diffusion tensor imaging in patients with carpal tunnel syndrome. Material and methodsThe study included a total of 77 wrists; 18 normal, 35 wrists with mild, 9 wrists with moderate and 15 wrists with severe carpal tunnel syndrome. Elastography of the median nerve was performed by defining the boundaries of a segment of the nerve at sagittal plane at the level of proximal carpal row. Additionally, the cross-sectional area of the median nerve was evaluated. Fractional anisotropy and apparent diffusion coefficient measurements were carried out by placing region-of-interest at three levels: at pisiform bone (carpal tunnel inlet), mid carpal tunnel, and hook of hamate (carpal tunnel outlet). ResultsPatients with carpal tunnel syndrome had higher elasticity values of median nerve (53.0 kPa; IQR 40.8–77.0 kPa) compared to control subjects. (36.8 kPa; IQR 31.0–39.9 kPa) Patients with moderate-severe carpal tunnel syndrome had higher elasticity values (82 kPa; IQR 64.0–95.5 kPa) compared to patients with mild carpal tunnel syndrome. (44 kPa; IQR 32.5–59.5 kPa)Patients with carpal tunnel syndrome had lower fractional anisotropy at mid-carpal level (0.382; IQR 0.330–0.495) compared to the control group. (0.494; IQR 0.434–0.537) Patients with moderate-severe carpal tunnel syndrome had lower fractional anisotropy values (0.366; IQR 0.331–0.407) and higher apparent diffusion coefficient values (1.509 mm2/s; IQR 1.374–1.733 mm2/s) compared to patients with mild carpal tunnel syndrome. (0,423; IQR 0.324–0.526 and 1.293 mm2/s; IQR 0.967–1.514 mm2/s) ConclusionShear-wave elastography and diffusion tensor imaging are helpful imaging modalities in diagnosing carpal tunnel syndrome and assessing its severity.