Magnetic resonance neurography: current perspectives and literature review
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Magnetic resonance neurography (also called MRN or MR neurography) refers to MR imaging dedicated to the peripheral nerves. It is a technique that enhances selective multiplanar visualisation of the peripheral nerve and pathology by encompassing a combination of two-dimensional, three-dimensional and diffusion imaging pulse sequences. Referring physicians who seek imaging techniques that can depict and diagnose peripheral nerve pathologies superior to conventional MR imaging are driving the demand for MRN. This article reviews the pathophysiology of peripheral nerves in common practice scenarios, technical considerations of MRN, current indications of MRN, normal and abnormal neuromuscular appearances, and imaging pitfalls. Finally, the emerging utility of diffusion-weighted and diffusion tensor imaging is discussed and future directions are highlighted.
• Lesion relationship to neural architecture is more conspicuous on MRN than MRI.
• 3D multiplanar imaging technique is essential for pre-surgical planning.
• Nerve injuries can be classified on MRN using Sunderland’s classification.
• DTI provides quantitative information and insight into intraneural integrity and pathophysiology.
KeywordsMRN MR neurography DTI Peripheral nerve MRI
The authors acknowledge the contribution of Mr. Jon Garinn in editing this manuscript and Dr. Jaya Trivedi for editing the electrophysiology section of the manuscript.
Compliance with ethical standards
The scientific guarantor of this publication is Avneesh Chhabra, MD.
Conflict of interest
The authors of this manuscript declare relationships with the following companies
AC has received prior research grants from GE-AUR (GERRAF), Siemens Medical Solutions, Gatewood Fellowship Award and Integra Life Sciences unrelated to this work. He serves as a research consultant with ICON Medical group. He also receives book royalties from Jaypee, Elsevier and Wolters Kluwer.
Gustav Andreisek was co-worker of a study that resulted in a US patent (USPTO Number 12/947,256). He has received grants from the Swiss National Science Foundation (SNCF), Holcim, MayenfischTtrust and Siemens. He is currently Co-PI or Sub-PI in several third party-funded clinical trials at the University of Zurich where renumeration is given to the department he works for (sponsors include: Millennium Pharmaceuticals, Eli Lilly, GlaxoSmithKline, Cytheris SA, Roche, BioChemics, Novartis, Bristol-Meyers Squibb, TopoTarget, Otsuka and Merck Sharp & Dohme). The department also receives grants from Bayer and Guerbet and has ongoing research collaborations with Siemens, GE and Philips. Gustav Andreisek has given workshops and talks at a congress which was sponsored by Mepha Pharma AG, Switzerland, and received a speaker fee. He also gives talks at Lunch symposia and CME courses, which are organized and sponsored by Guerbet AG, and receives speakers fees and travel reimbursements. He served as a consultant for Otsuka Pharmaceutical Europe Ltd and Siemens Healthcare AG, Germany, and received a consultancy fee and reimbursement of travel costs. Furthermore, he has been invited in the past by AGFA, Bracco, GE, Philips and Siemens for official company receptions at international radiological congresses (RSNA, ECR, SGR). As a book author, Gustav Andreisek receives royalties from Springer, Heidelberg and as author of CME articles, he receives royalties from Rheuma Schweiz.
The other authors declare no relationships with any companies whose products or services may be related to the subject matter of the article.
The authors state that this work has not received any funding.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was not required for this study because it is a review article.
Institutional Review Board approval was not required because it is a review article.
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