Magnetic Resonance Neurography of Peripheral Nerve Lesions in the Lower Extremity

Kuntz, Charles; Blake, Lindsey; Britz, Gavin W.; Filler, Aaron G.; Hayes, Cecil E.; Goodkin, Robert; Tsuruda, Jay S.; Maravilla, K R; Kliot, Michel

doi:10.1097/00006123-199610000-00021

Cited by 105 publications

(43 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Others have also noted that abnormal peripheral nerves typically demonstrate abnormally high signal on T2-weighted images and that this correlates well with clinical and electrodiagnostic evidence of nerve injury. 9 In contrast, normal nerves are only minimally hyperintense to muscle and show no significant enhancement.…”

Section: Discussionmentioning

confidence: 99%

“…4,9,10 MR neurography has been used to detect and evaluate the extent of neural tumors, along with the degree of fascicular distortion caused by these neoplasms. It has been suggested that by distinguishing normal nerve from nerve tumor, and demonstrating the precise relationship of the nerve to the tumor, MR neurography can provide guidance for surgery and intraoperative monitoring.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Localized hypertrophic neuropathy: Magnetic resonance imaging findings and long-term follow-up

et al. 1999

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Localized hypertrophic neuropathy: Magnetic resonance imaging findings and long-term follow-up

et al. 1999

View full text Add to dashboard Cite

“…Ultrasound (Prevot et al, 1990;Leitjen et al, 1992;Lang et al, 1994;Dubuisson and Stevenaert, 1996;Aulisa et al, 1998) and CT (Firooznia et al, 1983;Pazzaglia, et al, 1989;Gambari et al, 1990;Antonini et al, 1991) have both been used in an attempt to characterize these cysts and their origins but have fallen short when compared to optimized MRI techniques and the superior soft-tissue contrast and high spatial resolution (Leon and Marano, 1987;Coakley et al, 1995;Kuntz et al, 1996;Uetani et al, 1998;Grant et al, 2004). Even MRI, however, may not be adequate to demonstrate joint connections, if optimized techniques are not used.…”

Section: Discussionmentioning

confidence: 99%

Application of three-dimensional rendering in joint-related ganglion cysts

2006

View full text Add to dashboard Cite

The origin of para-articular cysts is poorly understood and controversial. The relatively common, simple (extraneural) cysts are presumed to be derived from joints, although joint connections are not always established. Rarer complex cysts are thought by many to form de novo within nerves (intraneural ganglion cysts) or within vessels (adventitial cysts) (degenerative theory). We believe that these simple and complex ganglion cysts are joint-related (articular theory). Joint connections are often not readily appreciated with routine imaging or at surgery. Not identifying and/or treating joint connections frequently leads to cyst recurrence. More sophisticated imaging may enhance visualization of these joint connections. We created a 3D rendering technique to assess potential joint connections of simple and complex cysts localized to the knee and superior tibiofibular joints in patients with fibular (peroneal) neuropathy. Two- and three-dimensional data sets from MRI examinations were segmented semiautomatically by signal intensity with further refinement based on interaction with the user to identify specific anatomic structures, such as small nerves and vessels on serial images. The bone, cysts, nerves, and vessels were each assigned different color representations, and 3D renderings were created in ANALYZE using the data sets closest to isotropic (voxel with equal length in all dimensions) resolution as the primary background rendering. We selected four cases to illustrate the spectrum of pathology. In all of these cases, we demonstrated joint connections and correlated imaging and operative findings. Surgery addressing the cyst and the joint connection resulted in excellent outcomes; postoperative MRIs done more than 6 months later confirmed that there was no recurrence. In addition to highlighting the important relationship of these cysts to neighboring anatomic structures, this 3D technique allows visualization of "occult" connections not readily appreciated with standard MR imaging. We believe that these joint-related cysts have a common pathogenesis; they dissect through a capsular rent and follow the path of least resistance; they may form simple cysts by dissecting out into the soft tissue, or more complex cysts by dissecting within the epineurium of nerves or adventitia of vessels (along an articular branch), or various combinations of all of these types of cysts. Understanding the pathogenesis for cyst formation will improve surgical management and outcomes. We have adapted this 3D technique to enhance the visualization of cysts occurring at other joints.

show abstract

“…When used together with a clinical examination, MR imaging can confirm the presence of a mass and visualize the fine anatomical details of involved peripheral nerves. Magnetic resonance neurography 8,9,15 comprises a series of techniques that further enhance the contrast between peripheral nerves and surrounding tissues. By employing special pulse sequences, high-field strength scanners, and multiple phased-array coils optimized for a particular body region, an improved signal-tonoise ratio can be achieved, leading to a higher spatial resolution and greater contrast while maintaining an adequate FOV (Fig.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Imaging of peripheral nerve tumors

Singh¹,

Kliot²

2007

FOC

Self Cite

View full text Add to dashboard Cite

Recent advancements in the field of imaging, particularly magnetic resonance imaging, have improved the way peripheral nerve tumors are diagnosed, monitored, and treated both medically and surgically. When combined with the all-important clinical evaluation and electrodiagnostic studies, imaging permits a clinician to accomplish the following: identify the size, shape, location, and distribution of mass lesions; infer the risks in resecting a mass lesion by displaying its relationship to nearby nerve fascicles; determine growth rates when serial imaging studies are available; suggest the nature of the pathological entity; and visualize muscle denervation associated with nerve damage. The authors describe some of the commonly used imaging modalities and discuss their use in evaluating and treating peripheral nerve tumors and other mass lesions.

show abstract

Magnetic Resonance Neurography of Peripheral Nerve Lesions in the Lower Extremity

Abstract: MRN proved useful in the preoperative evaluation and planning of surgery in patients with peripheral nerve lesions.

Cited by 105 publications

References 45 publications

Localized hypertrophic neuropathy: Magnetic resonance imaging findings and long-term follow-up

Localized hypertrophic neuropathy: Magnetic resonance imaging findings and long-term follow-up

Application of three-dimensional rendering in joint-related ganglion cysts

Imaging of peripheral nerve tumors

Contact Info

Product

Resources

About