Peripheral Nerve Surgery: The Role of High-Resolution MR Neurography

High-resolution MRN is becoming increasingly available due to recent technical advancements, including higher magnetic field strengths (eg, 3T), 3D image acquisition, evolution of novel fat-suppression methods, and improved coil design. This review describes the MRN techniques for obtaining high-quality images of the peripheral nerves and their small branches and imaging findings in normal as well as injured nerves with relevant intraoperative correlations. Various microsurgical techniques in peripheral nerves, such as neurolysis, nerve repairs by using nerve grafts, and conduits are discussed, and MRN findings of surgically treated nerves are demonstrated

High-Resolution 3T MR Neurography of the Brachial Plexus and Its Branches, with Emphasis on 3D Imaging

With advancement in 3D imaging, better fat-suppression techniques, and superior coil designs for MR imaging and the increasing availability and use of 3T magnets, the visualization of the complexity of the brachial plexus has become facile. The relevant imaging findings are described for normal and pathologic conditions of the brachial plexus. These radiologic findings are supported by clinical and/or EMG/surgical data, and corresponding high-resolution MR neurography images are illustrated. Because the brachial plexus can be affected by a plethora of pathologies, resulting in often serious and disabling complications, a better radiologic insight has great potential in aiding physicians in rendering superior services to patients

Dual-energy computed tomography has limited sensitivity for non-tophaceous gout: A comparison study with tophaceous gout

10.1186/s12891-016-0943-9BMC Musculoskeletal Disorders1719

Anatomic MR imaging and functional diffusion tensor imaging of peripheral nerve tumors and tumorlike conditions

BACKGROUND AND PURPOSE:A number of benign and malignant peripheral nerve tumor and tumorlike conditions produce similar imaging features on conventional anatomic MR imaging. Functional MR imaging using DTI can increment the diagnostic performance in differentiation of these lesions. Our aim was to evaluate the role of 3T anatomic MR imaging and DTI in the characterization of peripheral nerve tumor and tumorlike conditions.MATERIALS AND METHODS:Twenty-nine patients (13 men, 16 women; mean age, 41 ± 18 years; range, 11-83 years) with a nerve tumor or tumorlike condition (25 benign, 5 malignant) underwent 3T MR imaging by using anatomic (n = 29), functional diffusion, DWI (n = 21), and DTI (n = 24) techniques. Images were evaluated for image quality (3-point scale), ADC of the lesion, tractography, and fractional anisotropy of nerves with interobserver reliability in ADC and FA measurements.RESULTS:No significant differences were observed in age (benign, 40 ± 18 versus malignant, 45 ± 19 years) and sex (benign, male/female = 12:12 versus malignant, male/female = 3:2) (P > .05). All anatomic (29/29, 100%) MR imaging studies received "good" quality; 20/21 (95%) DWI and 21/24 (79%) DTI studies received "good" quality. ADC of benign lesions (1.848 ± 0.40 × 10(-3) mm(2)/s) differed from that of malignant lesions (0.900 ± 0.25 × 10(-3) mm(2)/s, P .05). FA of involved nerves was lower than that in contralateral healthy nerves (P .05), with excellent intermethod reliability (ICC = 0.943 [95% CI, 0.836-0.980]). Tractography differences were observed in benign and malignant lesions.CONCLUSIONS:3T MR imaging and DTI are valuable methods for anatomic and functional evaluation of peripheral nerve lesions with excellent interobserver reliability. While tractography and low FA provide insight into neural integrity, low diffusivity values indicate malignancy in neural masses