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.