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CC BY 4.0 · J Brachial Plex Peripher Nerve Inj 2021; 16(01): e17-e23
DOI: 10.1055/s-0041-1729176
Review Article

Magnetic Resonance Neurography for Evaluation of Peripheral Nerves

Vanessa Ku
1   Department of Orthopaedic Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, United States
,
Cameron Cox
1   Department of Orthopaedic Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, United States
,
Andrew Mikeska
1   Department of Orthopaedic Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, United States
,
Brendan MacKay 
1   Department of Orthopaedic Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, United States
2   Department of Orthopaedic Surgery, University Medical Center, Lubbock, Texas, United States
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Abstract

Peripheral nerve injuries (PNIs) continue to present both diagnostic and treatment challenges. While nerve transections are typically a straightforward diagnosis, other types of PNIs, such as chronic or traumatic nerve compression, may be more difficult to evaluate due to their varied presentation and limitations of current diagnostic tools. As a result, diagnosis may be delayed, and these patients may go on to develop progressive symptoms, impeding normal activity. In the past, PNIs were diagnosed by history and clinical examination alone or techniques that raised concerns regarding accuracy, invasiveness, or operator dependency. Magnetic resonance neurography (MRN) has been increasingly utilized in clinical settings due to its ability to visualize complex nerve structures along their entire pathway and distinguish nerves from surrounding vasculature and tissue in a noninvasive manner. In this review, we discuss the clinical applications of MRN in the diagnosis, as well as pre- and postsurgical assessments of patients with peripheral neuropathies.

Keywords

magnetic resonance neurography - MRN - MRI - peripheral nerve imaging - nerve evaluation - peripheral nerve injury


Publikationsverlauf

Eingereicht: 01. Dezember 2020

Angenommen: 29. Januar 2021

Artikel online veröffentlicht:
14. Mai 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Tapp M, Wenzinger E, Tarabishy S, Ricci J, Herrera FA. The epidemiology of upper extremity nerve injuries and associated cost in the US Emergency Departments. Ann Plast Surg 2019; 83 (06) 676-680
    CrossrefPubMedGoogle Scholar
  • 2 Chen Y, Haacke EM, Li J. Peripheral nerve magnetic resonance imaging. F1000 Res 2019; 8: F1000 Faculty Rev-1803
    CrossrefPubMedGoogle Scholar
  • 3 Chhabra A, Belzberg AJ, Rosson GD. et al. Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management. Eur Radiol 2016; 26 (05) 1235-1244
    CrossrefPubMedGoogle Scholar
  • 4 Howe FA, Filler AG, Bell BA, Griffiths JR. Magnetic resonance neurography. Magn Reson Med 1992; 28 (02) 328-338
    CrossrefPubMedGoogle Scholar
  • 5 Filler AG, Howe FA, Hayes CE. et al. Magnetic resonance neurography. Lancet 1993; 341 (8846): 659-661
    CrossrefPubMedGoogle Scholar
  • 6 Ho MJ, Ciritsis A, Manoliu A. et al. Diffusion tensor imaging of the brachial plexus: a comparison between readout-segmented and conventional single-shot echo-planar imaging. Magn Reson Med Sci 2019; 18 (02) 150-157
    CrossrefPubMedGoogle Scholar
  • 7 Fisher S, Wadhwa V, Manthuruthil C, Cheng J, Chhabra A. Clinical impact of magnetic resonance neurography in patients with brachial plexus neuropathies. Br J Radiol 2016; 89 (1067): 20160503
    CrossrefPubMedGoogle Scholar
  • 8 Upadhyaya V, Upadhyaya DN, Bansal R, Pandey T, Pandey AK. MR neurography in Parsonage-Turner syndrome. Indian J Radiol Imaging 2019; 29 (03) 264-270
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 9 Yoshida T, Sueyoshi T, Suwazono S, Suehara M. Three-tesla magnetic resonance neurography of the brachial plexus in cervical radiculopathy. Muscle Nerve 2015; 52 (03) 392-396
    CrossrefPubMedGoogle Scholar
  • 10 Upadhyaya V, Upadhyaya DN. Current status of magnetic resonance neurography in evaluating patients with brachial plexopathy. Neurol India 2019; 67 (Supplement): S118-S124
    CrossrefPubMedGoogle Scholar
  • 11 Upadhyaya V, Upadhyaya DN, Kumar A, Pandey AK, Gujral R, Singh AK. Magnetic resonance neurography of the brachial plexus. Indian J Plast Surg 2015; 48 (02) 129-137
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 12 Zara G, Gasparotti R, Manara R. MR imaging of peripheral nervous system involvement: Parsonage-Turner syndrome. J Neurol Sci 2012; 315 (1-2): 170-171
    CrossrefPubMedGoogle Scholar
  • 13 Oberlin C, Béal D, Leechavengvongs S, Salon A, Dauge MC, Sarcy JJ. Nerve transfer to biceps muscle using a part of ulnar nerve for C5-C6 avulsion of the brachial plexus: anatomical study and report of four cases. J Hand Surg Am 1994; 19 (02) 232-237
    CrossrefPubMedGoogle Scholar
  • 14 Frueh FS, Ho M, Schiller A. et al. Magnetic resonance neurographic and clinical long-term results after Oberlin's transfer for adult brachial plexus injuries. Ann Plast Surg 2017; 78 (01) 67-72
    CrossrefPubMedGoogle Scholar
  • 15 Aggarwal A, Jana M, Kumar V, Srivastava DN, Garg K. MR neurography in intraosseous median nerve entrapment. World J Radiol 2017; 9 (10) 400-404
    CrossrefPubMedGoogle Scholar
  • 16 Thawait GK, Subhawong TK, Thawait SK. et al. Magnetic resonance neurography of median neuropathies proximal to the carpal tunnel. Skeletal Radiol 2012; 41 (06) 623-632
    CrossrefPubMedGoogle Scholar
  • 17 Chhabra A, Madhuranthakam AJ, Andreisek G. Magnetic resonance neurography: current perspectives and literature review. Eur Radiol 2018; 28 (02) 698-707
    CrossrefPubMedGoogle Scholar
  • 18 Bendszus M, Wessig C, Solymosi L, Reiners K, Koltzenburg M. MRI of peripheral nerve degeneration and regeneration: correlation with electrophysiology and histology. Exp Neurol 2004; 188 (01) 171-177
    CrossrefPubMedGoogle Scholar
  • 19 Agarwal A, Chandra A, Jaipal U. et al. Can imaging be the new yardstick for diagnosing peripheral neuropathy?-a comparison between high resolution ultrasound and MR neurography with an approach to diagnosis. Insights Imaging 2019; 10 (01) 104
    CrossrefPubMedGoogle Scholar
  • 20 Holzgrefe RE, Wagner ER, Singer AD, Daly CA. Imaging of the peripheral nerve: concepts and future direction of magnetic resonance neurography and ultrasound. J Hand Surg Am 2019; 44 (12) 1066-1079
    CrossrefPubMedGoogle Scholar
  • 21 Bao H, Wu C, Wang S. et al. Diffusion-weighted magnetic resonance neurography for the diagnosis of carpal tunnel syndrome: a pilot study. Clin Radiol 2017; 72 (02) 165-169
    CrossrefPubMedGoogle Scholar
  • 22 Cudlip SA, Howe FA, Clifton A, Schwartz MS, Bell BA. Magnetic resonance neurography studies of the median nerve before and after carpal tunnel decompression. J Neurosurg 2002; 96 (06) 1046-1051
    CrossrefPubMedGoogle Scholar
  • 23 Shen L, Masih S, Patel DB, Matcuk Jr GR. MR anatomy and pathology of the ulnar nerve involving the cubital tunnel and Guyon's canal. Clin Imaging 2016; 40 (02) 263-274
    CrossrefPubMedGoogle Scholar
  • 24 Kollmer J, Bäumer P, Milford D. et al. T2-signal of ulnar nerve branches at the wrist in Guyon's canal syndrome. PLoS One 2012; 7 (10) e47295
    CrossrefPubMedGoogle Scholar
  • 25 Chhabra A, Wadhwa V, Thakkar RS, Carrino JA, Dellon AL. Recurrent ulnar nerve entrapment at the elbow: correlation of surgical findings and 3-Tesla magnetic resonance neurography. Can J Plast Surg 2013; 21 (03) 186-189
    CrossrefPubMedGoogle Scholar
  • 26 Bäumer P, Weiler M, Ruetters M. et al. MR neurography in ulnar neuropathy as surrogate parameter for the presence of disseminated neuropathy. PLoS One 2012; 7 (11) e49742
    CrossrefPubMedGoogle Scholar
  • 27 Breitenseher JB, Kranz G, Hold A. et al. MR neurography of ulnar nerve entrapment at the cubital tunnel: a diffusion tensor imaging study. Eur Radiol 2015; 25 (07) 1911-1918
    CrossrefPubMedGoogle Scholar
  • 28 Petchprapa CN, Rosenberg ZS, Sconfienza LM, Cavalcanti CF, Vieira RL, Zember JS. MR imaging of entrapment neuropathies of the lower extremity. Part 1. The pelvis and hip. Radiographics 2010; 30 (04) 983-1000
    CrossrefPubMedGoogle Scholar
  • 29 Chalian M, Soldatos T, Faridian-Aragh N. et al. 3T magnetic resonance neurography of tibial nerve pathologies. J Neuroimaging 2013; 23 (02) 296-310
    CrossrefPubMedGoogle Scholar
  • 30 Chhabra A, Faridian-Aragh N. High-resolution 3-T MR neurography of femoral neuropathy. AJR Am J Roentgenol 2012; 198 (01) 3-10
    CrossrefPubMedGoogle Scholar
  • 31 Garwood ER, Duarte A, Bencardino JT. MR imaging of entrapment neuropathies of the lower extremity. Radiol Clin North Am 2018; 56 (06) 997-1012
    CrossrefPubMedGoogle Scholar
  • 32 Hernando MF, Cerezal L, Pérez-Carro L, Abascal F, Canga A. Deep gluteal syndrome: anatomy, imaging, and management of sciatic nerve entrapments in the subgluteal space. Skeletal Radiol 2015; 44 (07) 919-934
    CrossrefPubMedGoogle Scholar
  • 33 Chhabra A, Chalian M, Soldatos T. et al. 3-T high-resolution MR neurography of sciatic neuropathy. AJR Am J Roentgenol 2012; 198 (04) W357-64
    CrossrefPubMedGoogle Scholar
  • 34 Pham M, Wessig C, Brinkhoff J, Reiners K, Stoll G, Bendszus M. MR neurography of sciatic nerve injection injury. J Neurol 2011; 258 (06) 1120-1125
    CrossrefPubMedGoogle Scholar
  • 35 Eastlack J, Tenorio L, Wadhwa V, Scott K, Starr A, Chhabra A. Sciatic neuromuscular variants on MR neurography: frequency study and interobserver performance. Br J Radiol 2017; 90 (1079): 20170116
    CrossrefPubMedGoogle Scholar
  • 36 Chitranjan KH, Kandpal H, Madhusudhan KS. Sciatic hernia causing sciatica: MRI and MR neurography showing entrapment of sciatic nerve. Br J Radiol 2010; 83 (987) e65-e66
    CrossrefPubMedGoogle Scholar
  • 37 Polesello GC, Queiroz MC, Linhares JPT, Amaral DT, Ono NK. Anatomical variation of piriformis muscle as a cause of deep gluteal pain: diagnosis using MR neurography and treatment. Rev Bras Ortop 2013; 48 (01) 114-117
    CrossrefPubMedGoogle Scholar
  • 38 Filler AG, Haynes J, Jordan SE. et al. Sciatica of nondisc origin and piriformis syndrome: diagnosis by magnetic resonance neurography and interventional magnetic resonance imaging with outcome study of resulting treatment. J Neurosurg Spine 2005; 2 (02) 99-115
    CrossrefPubMedGoogle Scholar
  • 39 Yang HE, Park JH, Kim S. Usefulness of magnetic resonance neurography for diagnosis of piriformis muscle syndrome and verification of the effect after botulinum toxin type A injection: two cases. Medicine (Baltimore) 2015; 94 (38) e1504
    CrossrefPubMedGoogle Scholar
  • 40 Bucknor MD, Steinbach LS, Saloner D, Chin CT. Magnetic resonance neurography evaluation of chronic extraspinal sciatica after remote proximal hamstring injury: a preliminary retrospective analysis. J Neurosurg 2014; 121 (02) 408-414
    CrossrefPubMedGoogle Scholar
  • 41 Vaeggemose M, Haakma W, Pham M. et al. Diffusion tensor imaging MR Neurography detects polyneuropathy in type 2 diabetes. J Diabetes Complications 2020; 34 (02) 107439
    CrossrefPubMedGoogle Scholar
  • 42 Vaeggemose M, Pham M, Ringgaard S. et al. Magnetic resonance neurography visualizes abnormalities in sciatic and tibial nerves in patients with type 1 diabetes and neuropathy. Diabetes 2017; 66 (07) 1779-1788
    CrossrefPubMedGoogle Scholar
  • 43 Pham M, Oikonomou D, Hornung B. et al. Magnetic resonance neurography detects diabetic neuropathy early and with proximal predominance. Ann Neurol 2015; 78 (06) 939-948
    CrossrefPubMedGoogle Scholar
  • 44 Jende JME, Groener JB, Kender Z. et al. Structural nerve remodeling at 3-T MR neurography differs between painful and painless diabetic polyneuropathy in type 1 or 2 diabetes. Radiology 2020; 294 (02) 405-414
    CrossrefPubMedGoogle Scholar
  • 45 Jende JME, Groener JB, Oikonomou D. et al. Diabetic neuropathy differs between type 1 and type 2 diabetes: insights from magnetic resonance neurography. Ann Neurol 2018; 83 (03) 588-598
    CrossrefPubMedGoogle Scholar
  • 46 Pham M, Oikonomou D, Bäumer P. et al. Proximal neuropathic lesions in distal symmetric diabetic polyneuropathy: findings of high-resolution magnetic resonance neurography. Diabetes Care 2011; 34 (03) 721-723
    CrossrefPubMedGoogle Scholar
  • 47 Vaeggemose M, Pham M, Ringgaard S. et al. Diffusion tensor imaging MR neurography for the detection of polyneuropathy in type 1 diabetes. J Magn Reson Imaging 2017; 45 (04) 1125-1134
    CrossrefPubMedGoogle Scholar
  • 48 Noble J, Munro CA, Prasad VS, Midha R. Analysis of upper and lower extremity peripheral nerve injuries in a population of patients with multiple injuries. J Trauma 1998; 45 (01) 116-122
    CrossrefPubMedGoogle Scholar
  • 49 Robinson LR. Traumatic injury to peripheral nerves. Suppl Clin Neurophysiol 2004; 57: 173-186
    CrossrefPubMedGoogle Scholar
  • 50 Marquez Neto OR, Leite MS, Freitas T, Mendelovitz P, Villela EA, Kessler IM. The role of magnetic resonance imaging in the evaluation of peripheral nerves following traumatic lesion: where do we stand?. Acta Neurochir (Wien) 2017; 159 (02) 281-290
    CrossrefPubMedGoogle Scholar
  • 51 Martín Noguerol T, Barousse R, Gómez Cabrera M, Socolovsky M, Bencardino JT, Luna A. Functional MR neurography in evaluation of peripheral nerve trauma and postsurgical assessment. Radiographics 2019; 39 (02) 427-446
    CrossrefPubMedGoogle Scholar
  • 52 Deshmukh SD, Samet J, Fayad LM, Ahlawat S. Magnetic resonance neurography of traumatic pediatric peripheral nerve injury: beyond birth-related brachial palsy. Pediatr Radiol 2019; 49 (07) 954-964
    CrossrefPubMedGoogle Scholar
  • 53 Grant GA, Britz GW, Goodkin R, Jarvik JG, Maravilla K, Kliot M. The utility of magnetic resonance imaging in evaluating peripheral nerve disorders. Muscle Nerve 2002; 25 (03) 314-331
    CrossrefPubMedGoogle Scholar
  • 54 Upadhyaya V, Upadhyaya DN, Kumar A, Gujral RB. MR neurography in traumatic brachial plexopathy. Eur J Radiol 2015; 84 (05) 927-932
    CrossrefPubMedGoogle Scholar
  • 55 Smith AB, Gupta N, Strober J, Chin C. Magnetic resonance neurography in children with birth-related brachial plexus injury. Pediatr Radiol 2008; 38 (02) 159-163
    CrossrefPubMedGoogle Scholar
  • 56 Baltodano PA, Tong AJ, Chhabra A, Rosson GD. The role of magnetic resonance neurography in the postoperative management of peripheral nerve injuries. Neuroimaging Clin N Am 2014; 24 (01) 235-244
    CrossrefPubMedGoogle Scholar
  • 57 Schwarz D, Weiler M, Pham M, Heiland S, Bendszus M, Bäumer P. Diagnostic signs of motor neuropathy in MR neurography: nerve lesions and muscle denervation. Eur Radiol 2015; 25 (05) 1497-1503
    CrossrefPubMedGoogle Scholar
  • 58 Martín Noguerol T, Barousse R, Socolovsky M, Luna A. Quantitative magnetic resonance (MR) neurography for evaluation of peripheral nerves and plexus injuries. Quant Imaging Med Surg 2017; 7 (04) 398-421
    CrossrefPubMedGoogle Scholar
  • 59 Chhabra A, Zhao L, Carrino JA. et al. MR neurography: advances. Radiol Res Pract 2013; 2013: 809568
    PubMedGoogle Scholar