Magnetic Resonance Neurography of Peripheral Nerve Tumors and Tumorlike Conditions

Ahlawat, Shivani; Chhabra, Avneesh; Blakely, Jaishri

doi:10.1016/j.nic.2013.03.035

Cited by 87 publications

(119 citation statements)

References 75 publications

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“…2P) and T2-weighted (Fig. 2Q) imaging, and the contrast enhancement tends to be variable 1,12 (Fig. 2R).…”

Section: Fig 1 Case 1 Axial T1-weighted (A) T2-weighted (B) and mentioning

confidence: 99%

“…2G) and hyperintense on T2-weighted images (Fig. 2H) and show characteristic homogeneous enhancement after gadolinium administration 1,12 (Fig. 2I).…”

Section: Fig 1 Case 1 Axial T1-weighted (A) T2-weighted (B) and mentioning

confidence: 99%

“…MRI commonly demonstrates diffuse multifocal nerve enlargement with variable degrees of enhancement; lymphoma is relatively more commonly seen and is characterized by more intense enhancement. 1,12 Traumatic Neuroma. Traumatic neuromas are caused by a disorganized regrowth of axonal fibers in response to a direct injury of an individual nerve.…”

Section: Fig 1 Case 1 Axial T1-weighted (A) T2-weighted (B) and mentioning

confidence: 99%

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The almost-invisible perineurioma

Restrepo¹,

Amrami

Howe

et al. 2015

FOC

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Intraneural perineurioma is a rare, benign slow-growing lesion arising from the perineurial cells that surrounds the peripheral nerve fibers. Typically it presents during childhood and young adulthood as a motor mononeuropathy. MRI plays an essential role in the diagnosis and localization of the lesion, which appears as a fusiform enlargement of the nerve fascicles that enhances intensely with gadolinium. Despite the typical clinical and radiological features, intraneural perineurioma remains largely underdiagnosed because of the lack of familiarity with this entity, but also as a result of technical limitations with conventional MRI that is typically performed as a screening test over a large field of view and without contrast sequences. The purpose of this article is to present the pitfalls and pearls learned from years of experience in the diagnosis and management of this relatively rare condition. Clinical suspicion and detailed neurological examination followed by high-quality electrophysiological studies (EPS) must lead to an adequate preimaging localization of the lesion and narrowing of the imaging area. The use of high-resolution (3-T) MRI combined with gadolinium administration will allow adequate visualization of the internal anatomy of the nerve and help in differentiating other causes of neuropathy. In cases where the lesion is not recognized but clinical suspicion is high, possible errors must be assessed, including the EPS localization, area of imaging, MRI resolution, and slice thickness.

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“…2P) and T2-weighted (Fig. 2Q) imaging, and the contrast enhancement tends to be variable 1,12 (Fig. 2R).…”

Section: Fig 1 Case 1 Axial T1-weighted (A) T2-weighted (B) and mentioning

confidence: 99%

“…2G) and hyperintense on T2-weighted images (Fig. 2H) and show characteristic homogeneous enhancement after gadolinium administration 1,12 (Fig. 2I).…”

Section: Fig 1 Case 1 Axial T1-weighted (A) T2-weighted (B) and mentioning

confidence: 99%

Section: Fig 1 Case 1 Axial T1-weighted (A) T2-weighted (B) and mentioning

confidence: 99%

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The almost-invisible perineurioma

Restrepo¹,

Amrami

Howe

et al. 2015

FOC

View full text Add to dashboard Cite

show abstract

“…This method is useful to provide anatomical data and to detect pathologies such as tumors that affect the continuity of nerves 18, 19. More recently, diffusion tensor imaging of peripheral nerves has been introduced as a tool to quantify nerve damage and regeneration 20, 21, 22…”

Section: Introductionmentioning

confidence: 99%

MRI biomarkers of proximal nerve injury in CIDP

Lichtenstein

Sprenger

Weiss

et al. 2017

Ann Clin Transl Neurol

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ObjectiveTo evaluate the utility of nerve diffusion tensor imaging (DTI), nerve cross‐sectional area, and muscle magnetic resonance imaging (MRI) multiecho Dixon for assessing proximal nerve injury in chronic inflammatory demyelinating polyneuropathy (CIDP).MethodsIn this prospective observational cohort study, 11 patients with CIDP and 11 healthy controls underwent a multiparametric MRI protocol with DTI of the sciatic nerve and assessment of muscle proton‐density fat fraction of the biceps femoris and the quadriceps femoris muscles by multiecho Dixon MRI. Patients were longitudinally evaluated by MRI, clinical examination, and nerve conduction studies at baseline and after 6 months.ResultsIn sciatic nerves of CIDP patients, mean cross‐sectional area was significantly higher and fractional anisotropy value was significantly lower, compared to controls. In contrast, muscle proton‐density fat fraction was significantly higher in thigh muscles of patients with CIDP, compared to controls. MRI parameters showed high reproducibility at baseline and 6 months.InterpretationAdvanced MRI parameters demonstrate subclinical proximal nerve damage and intramuscular fat accumulation in CIDP. Data suggest DTI and multiecho Dixon MRI might be useful in estimating axonal damage and neurogenic muscle changes in CIDP.

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“…ADC is expressed in mm 2 /s, and allows quantifying and monitoring the edema within PN or plexus. In PN pathology, it is less common to find low ADC values, which usually indicates the presence of a solid lesion with reduced extracellular space such as neurogenic tumors (20).…”

Section: Adcmentioning

confidence: 99%

Quantitative magnetic resonance (MR) neurography for evaluation of peripheral nerves and plexus injuries

Noguerol¹,

Barousse²,

Socolovsky

et al. 2017

Quant. Imaging Med. Surg.

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Traumatic conditions of peripheral nerves and plexus have been classically evaluated by morphological imaging techniques and electrophysiological tests. New magnetic resonance imaging (MRI) studies based on 3D fat-suppressed techniques are providing high accuracy for peripheral nerve injury evaluation from a qualitative point of view. However, these techniques do not provide quantitative information. Diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) are functional MRI techniques that are able to evaluate and quantify the movement of water molecules within different biological structures. These techniques have been successfully applied in other anatomical areas, especially in the assessment of central nervous system, and now are being imported, with promising results for peripheral nerve and plexus evaluation. DWI and DTI allow performing a qualitative and quantitative peripheral nerve analysis, providing valuable pathophysiological information about functional integrity of these structures.In the field of trauma and peripheral nerve or plexus injury, several derived parameters from DWI and DTI studies such as apparent diffusion coefficient (ADC) or fractional anisotropy (FA) among others, can be used as potential biomarkers of neural damage providing information about fiber organization, axonal flow or myelin integrity. A proper knowledge of physical basis of these techniques and their limitations is important for an optimal interpretation of the imaging findings and derived data. In this paper, a comprehensive review of the potential applications of DWI and DTI neurographic studies is performed with a focus on traumatic conditions, including main nerve entrapment syndromes in both peripheral nerves and brachial or lumbar plexus.

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Magnetic Resonance Neurography of Peripheral Nerve Tumors and Tumorlike Conditions

Cited by 87 publications

References 75 publications

The almost-invisible perineurioma

The almost-invisible perineurioma

MRI biomarkers of proximal nerve injury in CIDP

Quantitative magnetic resonance (MR) neurography for evaluation of peripheral nerves and plexus injuries

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