Diffusion tensor imaging of the sciatic nerve in Charcot–Marie–Tooth disease type I patients: a prospective case–control study

  • Hyun Su Kim
  • Young Cheol YoonEmail author
  • Byung-Ok Choi
  • Wook Jin
  • Jang Gyu Cha
  • Jae-Hun Kim



This study aimed to evaluate whether diffusion tensor imaging (DTI) parameters and cross-sectional area (CSA) can differentiate between the sciatic nerve of Charcot–Marie–Tooth (CMT) disease type I (demyelinating form) patients and that of controls.


This prospective comparison study included 18 CMT type I patients and 18 age/sex-matched volunteers. Magnetic resonance imaging including DTI and axial T2-weighted Dixon sequence was performed for each subject. Region of interest analysis was independently performed by two radiologists on each side of the sciatic nerve at four levels: hamstring tendon origin (level 1), lesser trochanter of the femur (level 2), gluteus maximus tendon insertion (level 3), and mid-femur (level 4). Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were calculated. The CSA of the sciatic nerve bundle was measured using axial water-only image at each level. Comparisons of DTI parameters between the two groups were performed using the two-sample t test and Mann–Whitney U test. Interobserver agreement analysis was also conducted.


Interobserver agreement was excellent for all DTI parameter analyses. FA was significantly lower at all four levels in CMT patients than controls. RD, MD, and CSA were significantly higher at all four levels in CMT patients. AD was significantly higher at level 2 in CMT patients.


DTI assessment of the sciatic nerve is reproducible and can discriminate the demyelinating nerve pathology of CMT type I patients from normal nerves. The CSA of the sciatic nerve is also a potential parameter for diagnosing nerve abnormality in CMT type I patients.

Key Points

• Diffusion tensor imaging parameters of the sciatic nerve at proximal to mid-femur level revealed significant differences between the Charcot–Marie–Tooth disease patients and controls.

• The cross-sectional area of the sciatic nerve was significantly larger in the Charcot–Marie–Tooth disease patients.

• Interobserver agreement was excellent (intraclass coefficient > 0.8) for all diffusion tensor imaging parameter analyses.


Diffusion tensor imaging Magnetic resonance imaging Neuromuscular disease Sciatic nerve 



Axial diffusivity


Charcot–Marie–Tooth disease


Cross-sectional area


Diffusion tensor imaging


Fractional anisotropy


Mean diffusivity


Magnetic resonance imaging


Radial diffusivity


Receiver operating characteristic


Region of interest



This study has received funding by Bracco Imaging (PHO0162171).

Compliance with ethical standards


The scientific guarantor of this publication is Young Cheol Yoon.

Conflict of interest

The authors declare that they have no conflict of interest.

Statistics and biometry

Insuk Sohn and Hyeseung Kim, the staffs of Bioinformatics Center, kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional review board approval was obtained.


• prospective

• case–control study

• performed at one institution

Supplementary material

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Supplementary Table 1 (XLSX 10 kb)
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Supplementary Table 2 (XLSX 15 kb)
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Supplementary Table 3 (XLSX 10 kb)
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Supplementary Table 4 (XLSX 11 kb)


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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  1. 1.Department of Radiology, Samsung Medical Center, School of MedicineSungkyunkwan UniversitySeoulSouth Korea
  2. 2.Department of Health Sciences and Technology, SAIHSTSungkyunkwan UniversitySeoulSouth Korea
  3. 3.Department of Neurology, Samsung Medical Center, School of MedicineSungkyunkwan UniversitySeoulSouth Korea
  4. 4.Department of RadiologyKyung Hee University Hospital at GangdongSeoulSouth Korea
  5. 5.Department of RadiologySoonchunhyang University Bucheon HospitalBucheonSouth Korea

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