Magnetic Resonance Neurography for Evaluation of Peripheral Nerves.

Andrew Mikeska,Brendan Mackay,Vanessa Ku,Cameron Cox

doi:10.1055/s-0041-1729176

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.

Highlights

Peripheral nerve injuries (PNIs) are common, with an incidence of 16.9 per 100,000 citizens in the United States.[1]
PNIs, those that are not caused by trauma, are difficult to diagnose given that their presentation varies, and initial symptoms may be vague or misleading
Suspected peripheral neuropathies have been diagnosed by clinical presentation, nerve biopsy, and nerve conduction studies (NCSs).[2,3]

Summary

Introduction

Peripheral nerve injuries (PNIs) are common, with an incidence of 16.9 per 100,000 citizens in the United States.[1]. Diagnosis is critical in these cases, as symptoms can rapidly progress from mild to debilitating if treatment is delayed and/or inappropriate for the particular injury. Suspected peripheral neuropathies have been diagnosed by clinical presentation, nerve biopsy, and nerve conduction studies (NCSs).[2,3] nerve biopsy is an invasive procedure, and NCSs are not helpful in the case of severe nerve degeneration.[2] When the cause of nerve dysfunction is known and patients fail nonoperative treatment, neurolysis, decompression, and/or nerve transpositions are often performed to treat symptoms and complications of PNIs. Even when the cause of dysfunction is understood, nerve assessments may still be necessary to identify the site of neurologic compromise for surgical planning. We discuss the clinical applications of MRN in diagnosis, treatment, and posttreatment monitoring of both chronic and traumatic peripheral neuropathies

Methods

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Conclusion