High-Resolution Magnetic Resonance Imaging of the Human Median Nerve

Heddings, Archie A.; Bilgen, Mehmet; Nudo, Randolph J.; Toby, Bruce; McIff, Terence E.; Brooks, William M.

doi:10.1177/0888439004267074

Cited by 14 publications

(15 citation statements)

References 26 publications

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“…MRN allows to determine the extent of the nerve lesion along the nerve in proximodistal direction. Additional evaluation on cross-section discloses microstructural detail to assess the extent of fascicular involvement [6,8,14]. In our case series we could directly confirm a predominant peroneal involvement.…”

Section: Discussionsupporting

confidence: 53%

MR neurography of sciatic nerve injection injury

et al. 2011

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We report on magnetic resonance neurography (MRN) as a supplementary diagnostic tool in sciatic nerve injection injury. The object of the study was to test if T2-weighted (w) contrast within the sciatic nerve serves as an objective criterion for sciatic injection injury. Three patients presented with acute sensory and/or motor complaints in the distribution of the sciatic nerve after dorsogluteal injection and underwent MRN covering gluteal, thigh and knee levels. Native and contrast-enhanced T1-w images were employed to identify the tibial and peroneal division of the sciatic nerve while T2-w images with fat suppression allowed visualization of the site and extent of the nerve lesion. MRN in the two patients with clinically severe sensory and motor impairment correctly depicted sciatic injury: continuity of the T2-w lesion within the nerve at the lesion site and distal to it corresponded well to severe injury confirmed by NCS/EMG as axonotmetic or neurotmetic. Topography of the T2-w lesion on cross-section corresponded to predominant peroneal involvement; moreover, associated denervation patterns of distal target muscles were revealed. One of these patients completely recovered with concomitant complete regression of MRN abnormalities on follow-up. The third patient experienced transient sensory and mild motor impairment with complete recovery after 2 weeks. In this patient, T2-w signal within the nerve and distal target muscles remained normal indicating only mild, non-axonal nerve affliction. Our case series shows that MRN can be very useful in precisely determining the site of sciatic injection injury and may provide diagnostic criteria for the assessment of lesion severity and recovery.

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Section: Discussionsupporting

confidence: 53%

MR neurography of sciatic nerve injection injury

et al. 2011

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“…Other imaging modalities can also depict peripheral nerves, and some, such as magnetic resonance imaging (MRI), can do so with potentially greater resolution than ultrasound 7. Although introduced over a decade ago, magnetic resonance neurography has not become widely available.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic ultrasound for nerve transection

et al. 2007

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The current approach for localizing and assessing the severity of traumatic peripheral nerve injuries involves clinical evaluation and electrodiagnostic studies. However, the ability of this approach to determine the extent of nerve damage within the first 6 weeks after trauma is limited. This is problematic because outcome is improved with early surgical intervention after complete nerve transection. This led us to explore alternative techniques, such as imaging, for assessing peripheral nerve injuries. Twelve fresh cadavers were obtained and after inspection 20 arms were deemed suitable for inclusion in the study. Random sites were transected in median, ulnar, and radial nerves, and sham skin incisions were performed throughout the arm. These nerves were then systematically scanned by an ultrasonographer blinded to the nerve transection sites, who made a final decision as to whether the nerve was transected. High-resolution ultrasound was able to identify transected nerves in the upper extremity with 89% sensitivity and 95% specificity in fresh cadavers. This proof-of-concept study shows that ultrasound can accurately identify nerve transection, which should lead to further ultrasound studies in patients with traumatic peripheral nerve injuries.

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“…Evaluation of peripheral nerves at higher magnetic field strength (Fig. 6) may be important in surgical repairs after injuries, for the differentiation of inflammatory and degenerative changes, and for the identification of the exact origin of tumors (i.e., perineural or intraneural) [40,52].…”

Section: Future Perspectives Of Musculoskeletal Imaging At 30 Tmentioning

confidence: 99%

Muskuloskeletal MR imaging at 3.0 T: current status and future perspectives

2006

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Magnetic resonance (MR) imaging has become an important diagnostic tool in evaluation of the musculoskeletal system. While most examinations are currently performed at magnetic field strengths of 1.5 T or lower, whole-body MR systems operating at 3.0 T have recently become available for clinical use. The higher field strengths promise various benefits, including increased signal-tonoise ratios, enhanced T2* contrast, increased chemical shift resolution, and most likely a better diagnostic performance in various applications. However, the changed T1, T2, and T2* relaxation times, the increased resonance-frequency differences caused by susceptibility and chemicalshift differences, and the increased absorption of radiofrequency (RF) energy by the tissues pose new challenges and/or offer new opportunities for imaging at 3.0 T compared to 1.5 T. Some of these issues have been successfully addressed only in the very recent past. This review discusses technical aspects of 3.0 T imaging as far as they have an impact on clinical routine. An overview of the current data is presented, with a focus on areas where 3.0 T promises equivalent or improved performance compared 1.5 T or lower field strengths.

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High-Resolution Magnetic Resonance Imaging of the Human Median Nerve

Abstract: Application of these imaging techniques to clinical scanners could provide physicians with a tool that is capable of grading the severity of nerve injuries and providing indications for surgery in the early postinjury phase.

Cited by 14 publications

References 26 publications

MR neurography of sciatic nerve injection injury

MR neurography of sciatic nerve injection injury

Diagnostic ultrasound for nerve transection

Muskuloskeletal MR imaging at 3.0 T: current status and future perspectives

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