Skeletal Radiology

, 40:1249

3 Tesla MR neurography—technique, interpretation, and pitfalls

  • Avneesh Chhabra
  • Pearlene P. Lee
  • Cary Bizzell
  • Theodoros Soldatos
Review Article

Abstract

MRI has been used for almost two decades for the evaluation of peripheral nerve disorders. This article highlights the relative advantages and disadvantages of 3T MR neurography in the evaluation of peripheral neuropathies. The authors also describe the high-resolution MR neurography technique on 3T MRI, along with the approach to its interpretation that has evolved at one institution.

Keywords

MR neurography 3 Tesla MRI Peripheral neuropathies Peripheral nerve disorders Nerve injuries 

References

  1. 1.
    Bendszus M, Koltzenburg M, Wessig C, Solymosi L. Sequential MR imaging of denervated muscle: experimental study. AJNR Am J Neuroradiol. 2002;23(8):1427–31.PubMedGoogle Scholar
  2. 2.
    Chang KJ, Kamel IR, Macura KJ, Bluemke DA. 3.0-T MR imaging of the abdomen: comparison with 1.5 T. Radiographics. 2008;28(7):1983–98.PubMedCrossRefGoogle Scholar
  3. 3.
    Chappell KE, Robson MD, Stonebridge-Foster A, Glover A, Allsop JM, Williams AD, et al. Magic angle effects in MR neurography. AJNR Am J Neuroradiol. 2004;25(3):431–40.PubMedGoogle Scholar
  4. 4.
    Chhabra A, Subhawong TK, William EH, Wang KC, Hashemi S, Thawait SK, Carrino JA. High resolution MR neurography evaluation prior to repeat tarsal tunnel surgery. AJR Am J Roentgenol. 2011;197. doi:10.2214/AJR.10.5763.
  5. 5.
    Chhabra A, Williams EH, Subhawong TK, Hashemi S, Soldatos T, Wang KC, et al. MR neurography findings of soleal sling entrapment. AJR Am J Roentgenol. 2011;196(3):W290–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Chhabra A, Williams EH, Wang KC, Dellon AL, Carrino JA. MR neurography of neuromas related to nerve injury and entrapment with surgical correlation. AJNR Am J Neuroradiol. 2010;31(8):1363–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Choi JY, Kim MJ, Chung YE, Kim JY, Jones AC, De Becker J, et al. Abdominal applications of 3.0-T MR imaging: comparative review versus a 1.5-T system. Radiographics. 2008;28(4):e30.PubMedCrossRefGoogle Scholar
  8. 8.
    Dellon AL. Management of peripheral nerve problems in the upper and lower extremity using quantitative sensory testing. Hand Clin. 1999;15(4):697–715.PubMedGoogle Scholar
  9. 9.
    Filler A. Magnetic resonance neurography and diffusion tensor imaging: origins, history, and clinical impact of the first 50,000 cases with an assessment of efficacy and utility in a prospective 5000-patient study group. Neurosurgery. 2009;65(4 Suppl):A29–43.PubMedCrossRefGoogle Scholar
  10. 10.
    Filler AG, Kliot M, Howe FA, Hayes CE, Saunders DE, Goodkin R, et al. Application of magnetic resonance neurography in the evaluation of patients with peripheral nerve pathology. J Neurosurg. 1996;85(2):299–309.PubMedCrossRefGoogle Scholar
  11. 11.
    Hof JJ, Kliot M, Slimp J, Haynor DR. What's new in MRI of peripheral nerve entrapment? Neurosurg Clin N Am. 2008;19(4):583–95. vi.PubMedCrossRefGoogle Scholar
  12. 12.
    Iba K, Wada T, Tamakawa M, Aoki M, Yamashita T. Diffusion-weighted magnetic resonance imaging of the ulnar nerve in cubital tunnel syndrome. Hand Surg. 2010;15(1):11–5.PubMedCrossRefGoogle Scholar
  13. 13.
    Jablecki CK, Andary MT, So YT, Wilkins DE, Williams FH. Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. AAEM Quality Assurance Committee. Muscle Nerve. 1993;16:1392–414.PubMedCrossRefGoogle Scholar
  14. 14.
    Jambawalikar S, Baum J, Button T, Li H, Geronimo V, Gould ES. Diffusion tensor imaging of peripheral nerves. Skeletal Radiol. 2010;39(11):1073–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Koltzenburg M, Bendszus M. Imaging of peripheral nerve lesions. Curr Opin Neurol. 2004;17(5):621–6.PubMedCrossRefGoogle Scholar
  16. 16.
    Kuntz CT, Blake L, Britz G, Filler A, Hayes CE, Goodkin R, et al. Magnetic resonance neurography of peripheral nerve lesions in the lower extremity. Neurosurgery. 1996;39(4):750–6. discussion 756–757.PubMedCrossRefGoogle Scholar
  17. 17.
    Kuwabara S, Nakajima M, Matsuda S, Hattori T. Magnetic resonance imaging at the demyelinative foci in chronic inflammatory demyelinating polyneuropathy. Neurology. 1997;48(4):874–7.PubMedGoogle Scholar
  18. 18.
    Lehmann HC, Zhang J, Mori S, Sheikh KA. Diffusion tensor imaging to assess axonal regeneration in peripheral nerves. Exp Neurol. 2010;223(1):238–44.PubMedCrossRefGoogle Scholar
  19. 19.
    Moore KR, Tsuruda JS, Dailey AT. The value of MR neurography for evaluating extraspinal neuropathic leg pain: a pictorial essay. AJNR Am J Neuroradiol. 2001;22(4):786–94.PubMedGoogle Scholar
  20. 20.
    Mukherjee P, Chung SW, Berman JI, Hess CP, Henry RG. Diffusion tensor MR imaging and fiber tractography: technical considerations. AJNR Am J Neuroradiol. 2008;29(5):843–52.PubMedCrossRefGoogle Scholar
  21. 21.
    Naganawa S, Ishihara S, Satake H, Kawai H, Sone M, Nakashima T. Simultaneous three-dimensional visualization of the intra-parotid facial nerve and parotid duct using a three-dimensional reversed FISP sequence with diffusion weighting. Magn Reson Med Sci. 2010;9(3):153–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Nanko S, Oshima H, Watanabe T, Sasaki S, Hara M, Shibamoto Y. Usefulness of the application of the BLADE technique to reduce motion artifacts on navigation-triggered prospective acquisition correction (PACE) T2-weighted MRI (T2WI) of the liver. J Magn Reson Imaging. 2009;30(2):321–6.PubMedCrossRefGoogle Scholar
  23. 23.
    Peer S, Bodner G, Meirer R, Willeit J, Piza-Katzer H. Examination of postoperative peripheral nerve lesions with high-resolution sonography. AJR Am J Roentgenol. 2001;177(2):415–9.PubMedGoogle Scholar
  24. 24.
    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(4):983–1000.PubMedCrossRefGoogle Scholar
  25. 25.
    Stuart RM, Koh ES, Breidahl WH. Sonography of peripheral nerve pathology. AJR Am J Roentgenol. 2004;182(1):123–9.PubMedGoogle Scholar
  26. 26.
    Tagliafico A, Succio G, Emanuele Neumaier C, Serafini G, Ghidara M, Calabrese M, Martinoli C. MR imaging of the brachial plexus: comparison between 1.5-T and 3-T MR imaging: preliminary experience. Skeletal Radiol. 2010;40(6):717–24.Google Scholar
  27. 27.
    Tagliafico A, Succio G, Neumaier CE, Baio G, Serafini G, Ghidara M, Calabrese M, Martinoli C. Brachial plexus assessment with three-dimensional isotropic resolution fast spin echo MRI: comparison with conventional MRI at 3.0 T. Br J Radiol. 2011 Feb 22. [Epub ahead of print].Google Scholar
  28. 28.
    Thawait SK, Chaudhry V, Thawait GK, Wang KC, Belzberg A, Carrino JA, et al. High-resolution MR neurography of diffuse peripheral nerve lesions. AJNR Am J Neuroradiol. 2010. doi:10.3174/ajnr.A2257.
  29. 29.
    Toros T, Karabay N, Ozaksar K, Sugun TS, Kayalar M, Bal E. Evaluation of peripheral nerves of the upper limb with ultrasonography: a comparison of ultrasonographic examination and the intra-operative findings. J Bone Joint Surg Br. 2009;91(6):762–5.PubMedCrossRefGoogle Scholar
  30. 30.
    Viallon M, Vargas MI, Jlassi H, Lovblad KO, Delavelle J. High-resolution and functional magnetic resonance imaging of the brachial plexus using an isotropic 3D T2 STIR (short term inversion recovery) SPACE sequence and diffusion tensor imaging. Eur Radiol. 2008;18:1018–23.PubMedCrossRefGoogle Scholar
  31. 31.
    Yamabe E, Nakamura T, Oshio K, Kikuchi Y, Ikegami H, Toyama Y. Peripheral nerve injury: diagnosis with MR imaging of denervated skeletal muscle–experimental study in rats. Radiology. 2008;247(2):409–17.PubMedCrossRefGoogle Scholar

Copyright information

© ISS 2011

Authors and Affiliations

  • Avneesh Chhabra
    • 1
  • Pearlene P. Lee
    • 1
  • Cary Bizzell
    • 1
  • Theodoros Soldatos
    • 1
  1. 1.Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins HospitalBaltimoreUSA

Personalised recommendations