Faculty Opinions recommendation of Magnetic resonance neurography: current perspectives and literature review.

Diagnosis of spontaneous fascicular nerve torsions is difficult and often delayed until surgical exploration is performed. This case series raises awareness of peripheral nerve torsions and will facilitate an earlier diagnosis by using nerve ultrasound (NUS) and magnetic resonance neurography (MRN). Four patients with previously ambiguous upper-extremity mononeuropathies underwent NUS and 3T MRN. Neuroimaging detected proximal torsions of the anterior and posterior interosseous nerve fascicles within median or radial nerve trunks in all patients. In NUS, most cases presented with a thickening of affected nerve fascicles, followed by an abrupt caliber decrease, leading to the pathognomonic sausage-like configuration. MRN showed T2-weighted hyperintense signal alterations of fascicles at and distal to the torsion site, and directly visualized the distorted nerves. Three patients had favorable outcomes after being transferred to emergency surgical intervention, while 1 patient with existing chronic muscle atrophy was no longer eligible for surgery. NUS and MRN are complementary diagnostic methods, and both can detect nerve torsions on a fascicular level. Neuroimaging is indispensable for diagnosing fascicular nerve torsions, and should be applied in all unclear cases of mononeuropathy to determine the diagnosis and if necessary, to guide surgical therapies, as only timely interventions enable favorable outcomes.

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Faculty Opinions recommendation of Magnetic resonance neurography and diffusion tensor imaging of the peripheral nerves in patients with Charcot-Marie-Tooth Type 1A.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727611887.793566457 ◽

2019 ◽

Author(s):

Jun Li

Keyword(s):

Diffusion Tensor Imaging ◽

Magnetic Resonance ◽

Peripheral Nerves ◽

Diffusion Tensor ◽

Magnetic Resonance Neurography ◽

Charcot Marie Tooth ◽

Tooth Type ◽

And Diffusion

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Neuralgic amyotrophy: an underrecognized entity

Journal of International Medical Research ◽

10.1177/03000605211006542 ◽

2021 ◽

Vol 49 (4) ◽

pp. 030006052110065

Author(s):

Tae Uk Kim ◽

Min Cheol Chang

Keyword(s):

Clinical Practice ◽

Magnetic Resonance ◽

Clinical Manifestations ◽

Clinical History ◽

Cervical Radiculopathy ◽

Sudden Onset ◽

Clinical Findings ◽

Magnetic Resonance Neurography ◽

Essential Information ◽

Neuralgic Amyotrophy

Neuralgic amyotrophy (NA) is markedly underdiagnosed in clinical practice, and its actual incidence rate is about 1 per 1000 per year. In the current article, we provide an overview of essential information about NA, including the etiology, clinical manifestations, diagnostic investigations, differential diagnosis, treatment, and prognosis. The causes of NA are multifactorial and include immunological, mechanical, or genetic factors. Typical clinical findings are a sudden onset of pain in the shoulder region, followed by patchy flaccid paralysis of muscles in the shoulder and/or arm. A diagnosis of NA is based on a patient’s clinical history and physical examination. Gadolinium-enhanced magnetic resonance imaging and high-resolution magnetic resonance neurography are useful for confirming the diagnosis and choosing the appropriate treatment. However, before a diagnosis of NA is confirmed, other disorders with similar symptoms, such as cervical radiculopathy or rotator cuff tear, need to be ruled out. The prognosis of NA depends on the degree of axonal damage. In conclusion, many patients with motor weakness and pain are encountered in clinical practice, and some of these patients will exhibit NA. It is important that clinicians understand the key features of this disorder to avoid misdiagnosis.

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Ferumoxytol-enhanced vascular suppression in magnetic resonance neurography

Skeletal Radiology ◽

10.1007/s00256-021-03804-w ◽

2021 ◽

Author(s):

Sophie C. Queler ◽

Ek Tsoon Tan ◽

Christian Geannette ◽

Martin Prince ◽

Darryl B. Sneag

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Neurography

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Early Treatment in Acute Severe Encephalopathy Caused by ATP1A2 Mutation of Familial Hemiplegic Migraine Type 2: Case Report and Literature Review

Neuropediatrics ◽

10.1055/s-0039-3400986 ◽

2019 ◽

Vol 51 (03) ◽

pp. 215-220

Author(s):

Ying Du ◽

Chuan Li ◽

Feng-ju Duan ◽

Chao Zhao ◽

Wei Zhang

Keyword(s):

Magnetic Resonance ◽

Literature Review ◽

Neuronal Damage ◽

Brain Magnetic Resonance Imaging ◽

Familial Hemiplegic Migraine ◽

Resonance Spectroscopy ◽

Rapid Progression ◽

Complete Disappearance ◽

Hemiplegic Migraine

AbstractFamilial hemiplegic migraine type 2 (FHM2) is an autosomal dominant inheritance disorder caused by ATP1A2 mutation, and the clinical spectrum is heterogeneous even with acute severe encephalopathy. However, up to now, early treatments against acute and severe attacks in FHM2 are still insufficient. Here, we report a 15-year-old female with intellectual disability due to FHM2 caused by a pathogenic ATP1A2 gene mutation, presenting mild-to-moderate headache at the onset, followed by confusion, complete right hemiparalysis, epileptic partial seizures, and conscious disturbance with rapid progression in acute attack. Brain magnetic resonance imaging (MRI) and magnetic resonance spectroscopy have revealed left extensive cerebral cortex edema, slightly decreased N-acetylaspartate for neuronal damage, and mildly increased lactate acid for mitochondrial dysfunction throughout the hemispheric swollen cortex. The patient is diagnosed as severe encephalopathy caused by FHM2. Based on literature review about pathophysiologic mechanism described in FHM2 recently, we use early treatments including prevention of glutamatergic excitotoxicity and protection of mitochondria function, as well as traditional antimigraine drug. The symptoms are all greatly improved and recovered within a short time, and follow-up MRI also shows complete disappearance of edema throughout the left hemispheric cortex. Altogether, the approach in our case may reduce the severity and duration of encephalopathy effectively, expend therapeutic options, and provide helpful references for acute severe encephalopathy in FHM2.

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Computed tomography and magnetic resonance imaging findings of intrasellar schwannoma: A case report and literature review

Oncology Letters ◽

10.3892/ol.2016.4182 ◽

2016 ◽

Vol 11 (3) ◽

pp. 2315-2319 ◽

Cited By ~ 3

Author(s):

MENGQI LIU ◽

YU OUYANG ◽

FAJIN LV

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Case Report ◽

Magnetic Resonance ◽

Literature Review ◽

Imaging Findings ◽

Resonance Imaging

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Application of magnetic resonance neurography in the evaluation of patients with peripheral nerve pathology

Journal of Neurosurgery ◽

10.3171/jns.1996.85.2.0299 ◽

1996 ◽

Vol 85 (2) ◽

pp. 299-309 ◽

Cited By ~ 178

Author(s):

Aaron G. Filler ◽

Michel Kliot ◽

Franklyn A. Howe ◽

Cecil E. Hayes ◽

Dawn E. Saunders ◽

...

Keyword(s):

Magnetic Resonance ◽

Time Course ◽

Spin Echo ◽

Fast Spin Echo ◽

Mr Neurography ◽

Magnetic Resonance Neurography ◽

Cross Sectional ◽

Content Type ◽

Direct Nerve ◽

Fine Print

✓ Currently, diagnosis and management of disorders involving nerves are generally undertaken without images of the nerves themselves. The authors evaluated whether direct nerve images obtained using the new technique of magnetic resonance (MR) neurography could be used to make clinically important diagnostic distinctions that cannot be readily accomplished using existing methods. The authors obtained T2-weighted fast spin—echo fat-suppressed (chemical shift selection or inversion recovery) and T1-weighted images with planes parallel or transverse to the long axis of nerves using standard or phased-array coils in healthy volunteers and referred patients in 242 sessions. Longitudinal and cross-sectional fascicular images readily distinguished perineural from intraneural masses, thus predicting both resectability and requirement for intraoperative electrophysiological monitoring. Fascicle pattern and longitudinal anatomy firmly identified nerves and thus improved the safety of image-guided procedures. In severe trauma, MR neurography identified nerve discontinuity at the fascicular level preoperatively, thus verifying the need for surgical repair. Direct images readily demonstrated increased diameter in injured nerves and showed the linear extent and time course of image hyperintensity associated with nerve injury. These findings confirm and precisely localize focal nerve compressions, thus avoiding some exploratory surgery and allowing for smaller targeted exposures when surgery is indicated. Direct nerve imaging can demonstrate nerve continuity, distinguish intraneural from perineural masses, and localize nerve compressions prior to surgical exploration. Magnetic resonance neurography can add clinically useful diagnostic information in many situations in which physical examinations, electrodiagnostic tests, and existing image techniques are inconclusive.

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