Diagnosis of lumbar radiculopathy using simultaneous MR neurography and apparent T2 mapping

Sato, Takashi; Eguchi, Yawara; Norimoto, Masaki; Inoue, Masahiro; Enomoto, Kazuyuki; Watanabe, Atsuya; Sakai, Takayuki; Yoneyama, Masami; Aoki, Yasuchika; Orita, Sumihisa; Suzuki-Narita, Miyako; Inage, Kazuhide; Umimura, Tomotaka; Sato, Masashi; Suzuki, Masahiro; Takaoka, Hiromitsu; Mizuki, Norichika; Kim, Geundong; Hozumi, Takashi; Hirosawa, Naoya; Furuya, Takeo; Maki, Satoshi; Nakamura, Junichi; Hagiwara, Shigeo; Koda, Masao; Akazawa, Tsutomu; Takahashi, Hiroshi; Takahashi, Kazuhisa; Ohtori, Seiji

doi:10.1016/j.jocn.2020.04.072

Cited by 8 publications

(9 citation statements)

References 34 publications

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“…One must consider, however, that all images used in this study were acquired at the same scanner and that DRG signal intensity was normalized to adjacent muscle tissue, which should make the results reproducible. In future studies, quantitative T2 imaging of DRG and the assessment of other quantitative MRN imaging parameters such as proton density and fractional anisotropy, that have been shown to be accurate markers of structural peripheral nerve integrity for different neuropathies, should be investigated ( Godel et al, 2016 ; Kollmer et al, 2018 ; Jende et al, 2019b , 2020 ; Sollmann et al, 2019 ; Sato et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Diabetic Polyneuropathy Is Associated With Pathomorphological Changes in Human Dorsal Root Ganglia: A Study Using 3T MR Neurography

et al. 2020

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Diabetic neuropathy (DPN) is one of the most severe and yet most poorly understood complications of diabetes mellitus. In vivo imaging of dorsal root ganglia (DRG), a key structure for the understanding of DPN, has been restricted to animal studies. These have shown a correlation of decreased DRG volume with neuropathic symptom severity. Our objective was to investigate correlations of DRG morphology and signal characteristics at 3 Tesla (3T) magnetic resonance neurography (MRN) with clinical and serological data in diabetic patients with and without DPN. In this cross-sectional study, participants underwent 3T MRN of both L5 DRG using an isotropic 3D T2weighted, fat-suppressed sequence with subsequent segmentation of DRG volume and analysis of normalized signal properties. Overall, 55 diabetes patients (66 ± 9 years; 32 men; 30 with DPN) took part in this study. DRG volume was smaller in patients with severe DPN when compared to patients with mild or moderate DPN (134.7 ± 21.86 vs 170.1 ± 49.22; p = 0.040). In DPN patients, DRG volume was negatively correlated with the neuropathy disability score (r = −0.43; 95%CI = −0.66 to −0.14; p = 0.02), a measure of neuropathy severity. DRG volume showed negative correlations with triglycerides (r = −0.40; 95%CI = −0.57 to −0.19; p = 0.006), and LDL cholesterol (r = −0.33; 95%CI = −0.51 to −0.11; p = 0.04). There was a strong positive correlation of normalized MR signal intensity (SI) with the neuropathy symptom score in the subgroup of patients with painful DPN (r = 0.80; 95%CI = 0.46 to 0.93; p = 0.005).

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Section: Discussionmentioning

confidence: 99%

Diabetic Polyneuropathy Is Associated With Pathomorphological Changes in Human Dorsal Root Ganglia: A Study Using 3T MR Neurography

et al. 2020

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“…An important study that used SHINEKI-Quant reported that the T2 relaxation times of the DRG and distal nerves were longer in patients with CIDP (119 ms and 111 ms, respectively) than they were in healthy subjects (101 ms and 85 ms, respectively) [16]. Sato et al [19] previously reported slightly longer lumbar DRG T2 relaxation times in healthy subjects (mean=115 ms), but in the current study, the T2 relaxation time of the cervical DRG in healthy subjects was consistent with those previous studies (mean=98.5 ms). Karampinos et al [28] reported that the T2 relaxation times were significantly longer in the DRG of L4 (78.0 ms) than in more distal parts of the nerve (59.5 ms).…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the size of the nerves was larger in patients with CIDP than in healthy subjects. Sato et al [ 19 ] reported that, in patients with lumbar radiculopathy, the T2 ratio was more diagnostic for radiculopathy than the T2 relaxation time alone. In patients with cervical radiculopathy, cervical neurography exposed enlargement of the affected nerves and prolonged T2 relaxation times compared with unaffected nerves on the contralateral side.…”

Section: Discussionmentioning

confidence: 99%

“…T2 relaxation time is usually measured from multislice multiecho spin echo sequences, which might be a shortcoming of MR neurography. We compared T2 relaxation times at 8 time points (TE: 24, 48, 72, 96, 120, 144, 168, and 192 ms) and those at 2 time points (SHINKEI-Quant; TE: 36 and 72 ms) in the rabbit spinal cord [ 19 ]. Using only 2 time points, SHINKEI-Quant calculated that relaxation times were 10–20 ms longer than when 8 time points were used [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Eguchi et al [ 18 ] previously reported that, in a patient with cervical radiculopathy caused by intervertebral disk herniation before microendoscopic surgery, neurography disclosed swelling of the compressed nerve and a longer T2 relaxation time than that of the unaffected contralateral nerve. Furthermore, the approach using the SHINKEI-Quant technique was successful in identifying lumbar radiculopathy [ 19 ]. The T2 ratio, defined as the T2 relaxation time on the affected side to unaffected side, was associated with leg pain in patients with lumbar radiculopathy.…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of Simultaneous Magnetic Resonance Neurography and Apparent T2 Mapping for the Diagnosis of Cervical Radiculopathy

et al. 2022

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We investigated the correlation between T2 relaxation times and clinical symptoms in patients with cervical radiculopathy caused by cervical disk herniation. Overview of Literature: There are currently no imaging modalities that can assess the affected cervical nerve roots quantitatively. Methods: A total of 14 patients with unilateral radicular symptoms and five healthy subjects were subjected to simultaneous apparent T2 mapping and neurography with nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation enhancement signaling (SHINKEI-Quant) using a 3-Tesla magnetic resonance imaging. The Visual Analog Scale (VAS) score for neck pain and upper arm pain was used to evaluate clinical symptoms. T2 relaxation times of the cervical dorsal root ganglia of the brachial plexus were measured bilaterally from C4 to C8 in patients with radicular symptoms and from C5 to C8 in healthy controls. The T2 ratio was calculated as the affected side to unaffected side.Results: When comparing nerve roots bilaterally at each spinal level, no significant differences in T2 relaxation times were found between patients and healthy subjects. However, T2 relaxation times of nerve roots in the patients with unilateral radicular symptoms were significantly prolonged on the involved side compared with the uninvolved side (p<0.05). The VAS score for upper arm pain was not significantly correlated with the T2 relaxation times, but was positively correlated with the T2 ratio.

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Diagnostic Testing of Neuropathic Pain

Tawfik

2022

Contemporary Rheumatology

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Diagnosis of lumbar radiculopathy using simultaneous MR neurography and apparent T2 mapping

Cited by 8 publications

References 34 publications

Diabetic Polyneuropathy Is Associated With Pathomorphological Changes in Human Dorsal Root Ganglia: A Study Using 3T MR Neurography

Diabetic Polyneuropathy Is Associated With Pathomorphological Changes in Human Dorsal Root Ganglia: A Study Using 3T MR Neurography

Usefulness of Simultaneous Magnetic Resonance Neurography and Apparent T2 Mapping for the Diagnosis of Cervical Radiculopathy

Diagnostic Testing of Neuropathic Pain

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