7T MR neurography‐ultrasound fusion for peripheral nerve imaging

Schreiber, Stefanie; Schreiber, Frank; Peter, Alica; Isler, Eser; Dörner, Marc; Heinze, Hans‐Jochen; Petri, S.; Tempelmann, Claus; Nestor, Peter J.; Grimm, Alexander; Vielhaber, Stefan

doi:10.1002/mus.26800

Cited by 10 publications

(7 citation statements)

References 25 publications

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“…Ziff et al identified pachymeningeal thickening in POEMS syndrome patients in contrast to patients with CIDP [26]. Combining HRUS and MRI might help to achieve even greater diagnostic accuracy, but future systematic studies are needed to prove this hypothesis [27]. MRI, especially diffusion tensor imaging (DTI) based tractography, might be used in the future to verify measurements by HRUS.…”

Section: Discussionmentioning

confidence: 99%

High-Resolution Nerve Ultrasound Abnormalities in POEMS Syndrome—A Comparative Study

et al. 2021

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Background: High-resolution nerve ultrasound (HRUS) has been proven to be a valuable tool in the diagnosis of immune-mediated neuropathies, such as chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes) is an important differential diagnosis of CIDP. Until now, there have been no studies that could identify specific HRUS abnormalities in POEMS syndrome patients. Thus, the aim of this study was to assess possible changes and compare findings with CIDP patients. Methods: We retrospectively analyzed HRUS findings in three POEMS syndrome and ten CIDP patients by evaluating cross-sectional nerve area (CSA), echogenicity and additionally calculating ultrasound pattern scores (UPSA, UPSB, UPSC and UPSS) and homogeneity scores (HS). Results: CIDP patients showed greater CSA enlargement and higher UPSS (median 14 vs. 11), UPSA (median 11.5 vs. 8) and HS (median 5 vs. 3) compared with POEMS syndrome patients. However, every POEMS syndrome patient illustrated enlarged nerves exceeding reference values, which were not restricted to entrapment sites. In CIDP and POEMS syndrome, heterogeneous enlargement patterns could be identified, such as inhomogeneous, homogeneous and regional nerve enlargement. HRUS in CIDP patients visualized both increased and decreased echointensity, while POEMS syndrome patients pictured hypoechoic nerves with hyperechoic intraneural connective tissue. Discussion: This is the first study to demonstrate HRUS abnormalities in POEMS syndrome outside of common entrapment sites. Although nerve enlargement was more prominent in CIDP, POEMS syndrome patients revealed distinct echogenicity patterns, which might aid in its differentiation from CIDP. Future studies should consider HRUS and its possible role in determining diagnosis, prognosis and treatment response in POEMS syndrome.

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Section: Discussionmentioning

confidence: 99%

High-Resolution Nerve Ultrasound Abnormalities in POEMS Syndrome—A Comparative Study

et al. 2021

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“…Other researchers made further investigations and found other applications of the method in neurology. [10] These authors used 7T MR neurography-ultrasound fusion for peripheral nerve imaging. They demonstrated the utility of UFI system for more accurate identification of Guillain-Barré syndrome and Charcot-Marie-Tooth disease type 1A.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound fusion imaging system in neurology practice

Peycheva¹,

Chervenkov²,

Harizanova³

et al. 2022

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The ultrasound fusion imaging (UFI) system is a new promising imaging modality that combines live ultrasound investigations with preregistered CT, MRI, or PET images. In this study, we want to present our initial experience with the new method that combines the transcranial color-coded sonography (TCCS) in different insonation planes and the 3T-weighted MRI cerebral images. The study validates the diagnostic capabilities of the system to detect different normal cerebral structures in healthy volunteers. In the present paper, we also discuss the advantages of US fusion imaging technology and its clinical applications in Neurology.

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“…Another advantage of combining both technologies is that they can compensate each other's limitations (HRUS: displaying distal nerves, nerve vascularization, long-distance nerve segments; MRN: showing blood-nerve barrier breakdown through T2 sequences, proximal nerve segments). Combining HRUS and MRN and applying new imaging markers might thereby be a promising approach to achieve even more conclusive and diagnosis-guiding results [14,39,40]. Of course, future systematic studies have to prove if combining both technologies will improve diagnostic accuracy [40].…”

Section: Discussionmentioning

confidence: 99%

“…Combining HRUS and MRN and applying new imaging markers might thereby be a promising approach to achieve even more conclusive and diagnosis-guiding results [14,39,40]. Of course, future systematic studies have to prove if combining both technologies will improve diagnostic accuracy [40]. Still, combining clinical examination, nerve conduction studies and HRUS is sufficient for the diagnosis of immune-mediated neuropathies in some cases and MRN is hence not necessary [13].…”

Section: Discussionmentioning

confidence: 99%

Peripheral Nerve Imaging Aids in the Diagnosis of Immune-Mediated Neuropathies—A Case Series

et al. 2020

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Background: Diagnosis of immune-mediated neuropathies and their differentiation from amyotrophic lateral sclerosis (ALS) can be challenging, especially at early disease stages. Accurate diagnosis is, however, important due to the different prognosis and available treatment options. We present one patient with a left-sided dorsal flexor paresis and initial suspicion of ALS and another with multifocal sensory deficits. In both, peripheral nerve imaging was the key for diagnosis. Methods: We performed high-resolution nerve ultrasound (HRUS) and 7T or 3T magnetic resonance neurography (MRN). Results: In both patients, HRUS revealed mild to severe, segmental or inhomogeneous, nerve enlargement at multiple sites, as well as an area increase of isolated fascicles. MRN depicted T2 hyperintense nerves with additional contrast-enhancement. Discussion: Peripheral nerve imaging was compatible with the respective diagnosis of an immune-mediated neuropathy, i.e., multifocal motor neuropathy (MMN) in patient 1 and multifocal acquired demyelinating sensory and motor neuropathy (MADSAM) in patient 2. Peripheral nerve imaging, especially HRUS, should play an important role in the diagnostic work-up for immune-mediated neuropathies and their differentiation from ALS.

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7T MR neurography‐ultrasound fusion for peripheral nerve imaging

Cited by 10 publications

References 25 publications

High-Resolution Nerve Ultrasound Abnormalities in POEMS Syndrome—A Comparative Study

High-Resolution Nerve Ultrasound Abnormalities in POEMS Syndrome—A Comparative Study

Ultrasound fusion imaging system in neurology practice

Peripheral Nerve Imaging Aids in the Diagnosis of Immune-Mediated Neuropathies—A Case Series

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