3-Tesla MRI-assisted detection of compression points in ulnar neuropathy at the elbow in correlation with intraoperative findings

Hold, Alina; Mayr-Riedler, Michael Stephan; Rath, Thomas; Pona, Igor; Nierlich, Patrick; Breitenseher, Julia; Kasprian, Gregor

doi:10.1016/j.bjps.2018.02.014

Cited by 8 publications

(5 citation statements)

References 22 publications

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“…In a study of ulnar neuropathy at the elbow, an axial T2-weighted MRI sequence was evaluated in the detection of compression points associated with ulnar neuropathy. While achieving a perfect correlation in 66% of cases between MRI findings and intra-operative observations, the study also demonstrates a fair-to-moderate level of correlation on Cohen Kappa's measure 61 .…”

Section: Discussionmentioning

confidence: 67%

Preoperative visualization of the greater occipital nerve with magnetic resonance imaging in candidates for occipital nerve decompression for headaches

Saad,

Manzanera Esteve,

Evans

et al. 2024

Sci Rep

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Occipital nerve decompression is effective in reducing headache symptoms in select patients with migraine and occipital neuralgia. Eligibility for surgery relies on subjective symptoms and responses to nerve blocks and Onabotulinum toxin A (Botox) injections. No validated objective method exists for detecting occipital headache pathologies. The purpose of the study is to explore the potential of high-resolution Magnetic Resolution Imaging (MRI) in identifying greater occipital nerve (GON) pathologies in chronic headache patients. The MRI protocol included three sequences targeting fat-suppressed fluid-sensitive T2-weighted signals. Visualization of the GON involved generating 2-D image slices with sequential rotation to track the nerve course. Twelve patients underwent pre-surgical MRI assessment. MRI identified four main pathologies that were validated against intra-operative examination: GON entanglement by the occipital artery, increased nerve thickness and hyperintensity suggesting inflammation compared to the non-symptomatic contralateral side, early GON branching with rejoining at a distal point, and a connection between the GON and the lesser occipital nerve. MRI possesses the ability to visualize the GON and identify suspected trigger points associated with headache symptoms. This case series highlights MRI's potential to provide objective evidence of nerve pathology. Further research is warranted to establish MRI as a gold standard for diagnosing extracranial contributors in headaches.

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Section: Discussionmentioning

confidence: 67%

Preoperative visualization of the greater occipital nerve with magnetic resonance imaging in candidates for occipital nerve decompression for headaches

Saad,

Manzanera Esteve,

Evans

et al. 2024

Sci Rep

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“…MRI studies of UNE are predominantly small and uncontrolled. Acknowledging these limitations, the reported sensitivity of increased intraneural T2 signal intensity is high, while specificity is variable 93–97 due to high rates of abnormal ulnar nerve signal in asymptomatic individuals 96 . Increased ulnar nerve CSA appears moderately sensitive but highly specific 93,96 .…”

Section: Focal Peripheral Nerve Disordersmentioning

confidence: 99%

Electrodiagnostic studies and new diagnostic modalities for evaluation of peripheral nerve disorders

Hannaford,

Paling,

Silsby

et al. 2024

Muscle and Nerve

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Electrodiagnostic studies (EDx) are frequently performed in the diagnostic evaluation of peripheral nerve disorders. There is increasing interest in the use of newer, alternative diagnostic modalities, in particular imaging, either to complement or replace established EDx protocols. However, the evidence to support this approach has not been expansively reviewed. In this paper, diagnostic performance data from studies of EDx and other diagnostic modalities in common peripheral nerve disorders have been analyzed and described, with a focus on radiculopathy, plexopathy, compressive neuropathies, and the important neuropathy subtypes of Guillain‐Barré syndrome, chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), vasculitic neuropathy and diabetic neuropathy. Overall EDx retains its place as a primary diagnostic modality in the evaluated peripheral nerve disorders. Magnetic resonance imaging and ultrasound have developed important complementary diagnostic roles in compressive and traumatic neuropathies and atypical CIDP, but their value is more limited in other neuropathy subtypes. Identification of hourglass constriction in nerves of patients with neuralgic amyotrophy may have therapeutic implications. Investigation of radiculopathy is confounded by poor correlation between clinical features and imaging findings and the lack of a diagnostic gold standard. There is a need to enhance the literature on the utility of these newer diagnostic modalities.

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“…The intraclass correlation coe cient of the intra-rater reliability and that of the inter-rater reliability were good-to-excellent (Table 1). [10] Therefore, we used the CSA measured by one of the raters.…”

Section: Mri Evaluationmentioning

confidence: 99%

Ulnar nerve morphology on magnetic resonance imaging predicts nerve recovery after surgery for cubital tunnel syndrome

Kim

Shah

Chae

et al. 2022

Hand Surgery and Rehabilitation

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3-Tesla MRI-assisted detection of compression points in ulnar neuropathy at the elbow in correlation with intraoperative findings

Cited by 8 publications

References 22 publications

Preoperative visualization of the greater occipital nerve with magnetic resonance imaging in candidates for occipital nerve decompression for headaches

Preoperative visualization of the greater occipital nerve with magnetic resonance imaging in candidates for occipital nerve decompression for headaches

Electrodiagnostic studies and new diagnostic modalities for evaluation of peripheral nerve disorders

Ulnar nerve morphology on magnetic resonance imaging predicts nerve recovery after surgery for cubital tunnel syndrome

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