Correlative high-resolution MR-anatomic study of sciatic, ulnar, and proper palmar digital nerve

Hörmann, Marcus; Traxler, Hannes; Ba‐Ssalamah, Ahmed; Mlynarik, Vladimir; Shodaj-Baghini, Mitra; Kubiena, Harald; Trattnig, Siegfried

doi:10.1016/s0730-725x(03)00188-7

Cited by 20 publications

(19 citation statements)

References 16 publications

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“…Various imaging criteria are helpful in differ- entiating a normal peripheral nerve from a diseased nerve ( Fig 1). 1,9 Intravenous administration of gadolinium is also helpful in detecting abnormal nerve and denervated muscle enhancement in patients suspected of various inflammatory, infectious, and neoplastic neuropathies.…”

Section: Normal and Abnormal Peripheral Nerves On Highresolution Mrn mentioning

confidence: 99%

High-Resolution MR Neurography of Diffuse Peripheral Nerve Lesions

Thawait¹,

Chaudhry²,

Thawait³

et al. 2010

AJNR Am J Neuroradiol

172

103

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SUMMARY:High-resolution MR imaging of peripheral nerves is becoming more common and practical with the increasing availability of 3T magnets. There are multiple reports of MR imaging of peripheral nerves in compression and entrapment neuropathies. However, there is a relative paucity of literature on MRN appearance of diffuse peripheral nerve lesions. We attempted to highlight the salient imaging features of myriad diffuse peripheral nerve disorders and imaging techniques for MRN. Using clinical and pathologically proved relevant examples, we present the MRN appearance of various types of diffuse peripheral nerve lesions, such as traumatic, inflammatory, infectious, hereditary, radiationinduced, neoplastic, and tumor variants.ABBREVIATIONS: CIDP ϭ chronic inflammatory demyelinating polyneuropathy; CMT ϭ CharcotMarie-Tooth; fat sat ϭ fat saturated; FLAIR ϭ fluid-attenuated inversion recovery; FLH ϭ fibrolipomatous hamartoma; GBS ϭ Guillain Barré syndrome; CMT/HSMN ϭ Charcot-Marie-Tooth/hereditary motor and sensory neuropathy; MMN ϭ multifocal motor neuropathy; MPNST ϭ malignant peripheral nerve sheath tumor; MRN ϭ MR neurography; NF1 ϭ neurofibromatosis type 1; NL ϭ neurolymphomatosis; SE ϭ spin-echo; SNR ϭ signal-to-noise ratio; SPACE ϭ sampling perfection with application-optimized contrasts by using different flip angle evolutions; SPAIR ϭ spectralattenuated inversion recovery; STIR ϭ short-tau inversion recovery; T1WI ϭ T1-weighted imaging; T1WIFS ϭ T1-weighted fat-saturated imaging; T2WI ϭ T2-weighted imaging; T2WIFS ϭ T2-weighted fat-saturated imaging H igh-resolution MR imaging of peripheral nerves is becoming more common and practical with increasing availability of 3T magnets. These magnets provide high SNR, which can be used for a quicker acquisition time as well as higher image contrast and resolution. There have been multiple reports of MR imaging of peripheral nerves in compression and entrapment neuropathies.1-3 However, there is a relative paucity of literature on the MRN appearance of diffuse peripheral nerve lesions. 4 These lesions seen on MR imaging present a diagnostic dilemma because a long list of pathologies could be causing them. We attempt to highlight the salient imaging features of myriad diffuse peripheral nerve disorders and to describe a diagnostic approach to these lesions on the basis of the available literature and our experience in this area. Various clinical and pathologically proved relevant examples of these pathologies are illustrated. . T1WI demonstrates fat planes delineating the normal nerve (perineural fat). C, Axial STIR SPACE at the level of the thighs shows an abnormal sciatic nerve. Notice the enlarged size and T2 hyperintensity of the fascicles. The dark rim of perineural fat is also disrupted. Also note posterior compartment denervation muscle edema (arrows).

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Section: Normal and Abnormal Peripheral Nerves On Highresolution Mrn mentioning

confidence: 99%

High-Resolution MR Neurography of Diffuse Peripheral Nerve Lesions

Thawait¹,

Chaudhry²,

Thawait³

et al. 2010

AJNR Am J Neuroradiol

172

103

View full text Add to dashboard Cite

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“…A previous report provided excellent MR imaging of cadaveric nerve specimens, with a small field of view (FOV) and large matrices [19]. In clinical studies, the signal changes of a nerve and its fascicles were well-defined in larger nerves, such as the following: nerves of the brachial and sacral plexus; the ulnar and median nerve at the arm, forearm and wrist; the radial nerve at the arm and forearm; the sciatic nerve in the thigh and the proximal tibia, and the common peroneal nerves in the thigh and popliteal fossa and leg [17].…”

Section: Mr Imaging Of Normal and Abnormal Peripheral Nervesmentioning

confidence: 99%

“…Axial T1WI at the same level (d) shows strand-like high signal intensity within the muscle. These findings are suggestive of muscle atrophy and fatty deposit in the chronic phase of denervation [19][20][21]. A normal nerve is usually visualized on T1-weighted MR imaging (T1WI) as a group of dark (relative to normal muscle) signal intensity spots of fascicles surrounded by high signal intensity connective tissue containing perineurial and epineurial fat components.…”

Section: Mr Imaging Of Normal and Abnormal Peripheral Nervesmentioning

confidence: 99%

Role of magnetic resonance imaging in entrapment and compressive neuropathy—what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 1. Overview and lower extremity

et al. 2006

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The diagnosis of nerve entrapment and compressive neuropathy has been traditionally based on the clinical and electrodiagnostic examinations. As a result of improvements in the magnetic resonance (MR) imaging modality, it plays not only a fundamental role in the detection of space-occupying lesions but also a compensatory role in clinically and electrodiagnostically inconclusive cases. Although ultrasound has undergone further development in the past decades and shows high resolution capabilities, it has inherent limitations due to its operator dependency. We review the general concepts that should be known to evaluate the entrapment and compressive neuropathy in MR imaging. We also review the course of normal peripheral nerves, as well as various clinical demonstrations and pathological features of compressed and entrapped nerves in the lower extremities on MR imaging, according to the nerves involved. The common sites of nerve entrapment of the lower extremity are as follows: sciatic nerve around the piriformis muscle; tibial nerve at the popliteal fossa and tarsal tunnel, common peroneal nerve around the fibular neck, and digital nerve near the metatarsal head. Although MR imaging can depict the peripheral nerves in the extremities effectively, radiologists should be familiar with nerve pathways, common sites of nerve compression, and common space-occupying lesions resulting in nerve compression in MR imaging.

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“…Thorough research of radiologic imaging methods is needed in order to understand and define their potential 6,14 . Developments in both hardware and software for magnetic resonance imaging (MRI) and ultrasound (US) imaging have improved image quality for delineating finer anatomical details of the nerves with the potential of demonstrating the fascicular anatomy 6,15,16 . Published studies on sonographic depiction predominantly use standard probes with which identification and quantification of fascicles characteristics is complex 2,4,5,12 .…”

Section: Introductionmentioning

confidence: 99%

Median and ulnar nerve fascicle imaging using MR microscopy and high‐resolution ultrasound

Snoj

Serša

Matičič

et al. 2022

Journal of Neuroimaging

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Background and Purpose: Understanding nerve microanatomy is important as different neuropathies and some nerve neoplasms present with fascicle enlargement. The aim of our study was to gain clinically oriented knowledge on nerve fascicular anatomy using imaging modalities.Methods: On a cadaveric upper extremity, high-resolution ultrasound (HRUS) scan with 22 MHz probe was performed. Sections of the median and ulnar nerves were excised at the level of the distal arm and after magnetic resonance microscopy (MRM), histological cross-sections (HCS) were prepared. Cross-referencing of the MRM and HRUS images with HCS was performed. Fascicle and nerve contouring was performed with morphometric software in order to assess nerve and fascicular cross-sectional area (CSA), fascicle count, and interfascicular distances. Based on fascicle differentiation, factual fascicle (FF) group and fascicular cluster (FC) group were defined.Results: On the cross-referenced imaging material, fascicles were differentiated in 92.7% on MRM and in 57.3% on HRUS. High to very high positive correlation among imaging material was observed for the fascicle CSA. FF depiction was 30.1% on HRUS. In comparison to the FF group, the FC group had significantly larger fascicle CSA and shorter interfascicular distances. Discussion:The findings of our study contribute to understanding of fascicle depiction on imaging modalities. HRUS offers good visualization of fascicles. The capability of differentiating fascicles is modality specific and depends on the fascicle CSA and the amount of interfascicular epineurium.

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Correlative high-resolution MR-anatomic study of sciatic, ulnar, and proper palmar digital nerve

Cited by 20 publications

References 16 publications

High-Resolution MR Neurography of Diffuse Peripheral Nerve Lesions

High-Resolution MR Neurography of Diffuse Peripheral Nerve Lesions

Role of magnetic resonance imaging in entrapment and compressive neuropathy—what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 1. Overview and lower extremity

Median and ulnar nerve fascicle imaging using MR microscopy and high‐resolution ultrasound

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