Abstract

Diagnostic imaging techniques play an important role in assessing the exact location, cause, and extent of a nerve lesion, thus allowing clinicians to diagnose and manage more effectively a variety of pathological conditions, such as entrapment syndromes, traumatic injuries, and space-occupying lesions. Ultrasound and nuclear magnetic resonance imaging are becoming useful methods for this purpose, but they still lack spatial resolution. In this regard, recent phase contrast x-ray imaging experiments of peripheral nerve allowed the visualization of each nerve fiber surrounded by its myelin sheath as clearly as optical microscopy. In the present study, we attempted to produce high-resolution x-ray phase contrast images of a human sciatic nerve by using synchrotron radiation propagation-based imaging. The images showed high contrast and high spatial resolution, allowing clear identification of each fascicle structure and surrounding connective tissue. The outstanding result is the detection of such structures by phase contrast x-ray tomography of a thick human sciatic nerve section. This may further enable the identification of diverse pathological patterns, such as Wallerian degeneration, hypertrophic neuropathy, inflammatory infiltration, leprosy neuropathy and amyloid deposits. To the best of our knowledge, this is the first successful phase contrast x-ray imaging experiment of a human peripheral nerve sample. Our long-term goal is to develop peripheral nerve imaging methods that could supersede biopsy procedures.

Highlights

  • The estimated peripheral neuropathy prevalence in the general population is approximately 2%, but it can achieve 8% in adults over 55 years of age [1]

  • Phase contrast radiography showed a clear distinction of the fascicular nerve architecture, surrounded by its connective tissue and blood vessels

  • Fascicle arrangement, and even nerve fiber diameter analysis were possible to be detected through phase contrast radiography

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Summary

Introduction

The estimated peripheral neuropathy prevalence in the general population is approximately 2%, but it can achieve 8% in adults over 55 years of age [1]. Because neuropathies have several causes, assessment and diagnosis may become challenging. Even with a proper assessment, that includes nerve conduction studies, between 25% and 40% of all neuropathies are PLOS ONE | DOI:10.1371/journal.pone.0116831. Peripheral Nerves and X-Ray Phase Contrast Imaging Even with a proper assessment, that includes nerve conduction studies, between 25% and 40% of all neuropathies are PLOS ONE | DOI:10.1371/journal.pone.0116831 March 10, 2015

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