scholarly journals Magnetic resonance neurography of the brachial plexus

2015 ◽  
Vol 48 (02) ◽  
pp. 129-137 ◽  
Author(s):  
Vaishali Upadhyaya ◽  
Divya Narain Upadhyaya ◽  
Adarsh Kumar ◽  
Ashok Kumar Pandey ◽  
Ratni Gujral ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Brachial Plexus ◽  
Peripheral Nerves ◽  
Imaging Modality ◽  
Nerve Tissue ◽  
Magnetic Resonance Neurography ◽  
Nerve Lesions ◽  
Peripheral Nerve Lesions ◽  
Magnetic Resonance Imaging Mri

ABSTRACTMagnetic Resonance Imaging (MRI) is being increasingly recognised all over the world as the imaging modality of choice for brachial plexus and peripheral nerve lesions. Recent refinements in MRI protocols have helped in imaging nerve tissue with greater clarity thereby helping in the identification, localisation and classification of nerve lesions with greater confidence than was possible till now. This article on Magnetic Resonance Neurography (MRN) is based on the authors’ experience of imaging the brachial plexus and peripheral nerves using these protocols over the last several years.

Magnetic resonance neurography for the evaluation of peripheral nerve, brachial plexus, and nerve root disorders

2010 ◽  
Vol 112 (2) ◽  
pp. 362-371 ◽  
Author(s):  
Rose Du ◽  
Kurtis I. Auguste ◽  
Cynthia T. Chin ◽  
John W. Engstrom ◽  
Philip R. Weinstein
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Nerve Root ◽  
Consecutive Series ◽  
Brachial Plexopathy ◽  
Magnetic Resonance Neurography ◽  
Nerve Lesions ◽  
Peripheral Nerve Lesions

Object Treatment of spinal and peripheral nerve lesions relies on localization of the pathology by the use of neurological examination, spinal MR imaging and electromyography (EMG)/nerve conduction studies (NCSs). Magnetic resonance neurography (MRN) is a novel imaging technique recently developed for direct imaging of spinal and peripheral nerves. In this study, the authors analyzed the role of MRN in the evaluation of spinal and peripheral nerve lesions. Methods Imaging studies, medical records, and EMG/NCS results were analyzed retrospectively in a consecutive series of 191 patients who underwent MRN for spinal and peripheral nerve disorders at the University of California, San Francisco between March 1999 and February 2005. Ninety-one (47.6%) of these patients also underwent EMG/NCS studies. Results In those who underwent both MRN and EMG/NCS, MRN provided the same or additional diagnostic information 32 and 45% of patients, respectively. Magnetic resonance neurograms were obtained at a median of 12 months after the onset of symptoms. The utility of MRN correlated with the interval between the onset of symptoms to MRN. Twelve patients underwent repeated MRN for serial evaluation. The decrease in abnormal signal detected on subsequent MRN correlated with time from onset of symptoms and the time interval between MRN, but not with resolution of symptoms. Twenty-one patients underwent MRN postoperatively to assess persistent, recurrent, or new symptoms; of these 3 (14.3%) required a subsequent surgery. Conclusions Magnetic resonance neurography is a valuable adjunct to conventional MR imaging and EMG/NCS in the evaluation and localization of nerve root, brachial plexus, and peripheral nerve lesions. The authors found that MRN is indicated in patients: 1) in whom EMG and traditional MR imaging are inconclusive; 2) who present with brachial plexopathy who have previously received radiation therapy to the brachial plexus region; 3) who present with brachial plexopathy and have systemic tumors; and 4) in patients under consideration for surgery for peripheral nerve lesions or after trauma. Magnetic resonance neurography is limited by the size of the nerve trunk imaged and the timing of the study.

scholarly journals High-resolution ultrasonography in evaluating peripheral nerve entrapment and trauma

2009 ◽  
Vol 26 (2) ◽  
pp. E13 ◽  
Author(s):  
Ralph W. Koenig ◽  
Maria T. Pedro ◽  
Christian P. G. Heinen ◽  
Thomas Schmidt ◽  
Hans-Peter Richter ◽  
...  
Keyword(s):  
High Resolution ◽  
Peripheral Nerve ◽  
Peripheral Nerves ◽  
Imaging Modality ◽  
Nerve Entrapment ◽  
Nerve Lesions ◽  
Peripheral Nerve Lesions ◽  
Continuous Progress ◽  
Number Of Publications ◽  
High Resolution Ultrasonography

High-resolution ultrasonography is a noninvasive, readily applicable imaging modality, capable of depicting real-time static and dynamic morphological information concerning the peripheral nerves and their surrounding tissues. Continuous progress in ultrasonographic technology results in highly improved spatial and contrast resolution. Therefore, nerve imaging is possible to a fascicular level, and most peripheral nerves can now be depicted along their entire anatomical course. An increasing number of publications have evaluated the role of high-resolution ultrasonography in peripheral nerve diseases, especially in peripheral nerve entrapment. Ultrasonography has been shown to be a precious complementary tool for assessing peripheral nerve lesions with respect to their exact location, course, continuity, and extent in traumatic nerve lesions, and for assessing nerve entrapment and tumors. In this article, the authors discuss the basic technical considerations for using ultrasoniography in peripheral nerve assessment, and some of the clinical applications are illustrated.

Magnetic Resonance Neurography of Peripheral Nerve Lesions in the Lower Extremity

Neurosurgery ◽  
1996 ◽  
Vol 39 (4) ◽  
pp. 750-756 ◽  
Author(s):  
Charles Kuntz ◽  
Lindsey Blake ◽  
Gavin Britz ◽  
Aaron Filler ◽  
Cecil E. Hayes ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Lower Extremity ◽  
Peripheral Nerve ◽  
Magnetic Resonance Neurography ◽  
Nerve Lesions ◽  
Peripheral Nerve Lesions

High-resolution ultrasonography in the diagnosis and intraoperative management of peripheral nerve lesions

2011 ◽  
Vol 114 (1) ◽  
pp. 206-211 ◽  
Author(s):  
Franklin C. Lee ◽  
Harminder Singh ◽  
Levon N. Nazarian ◽  
John K. Ratliff
Keyword(s):  
High Resolution ◽  
Peripheral Nerve ◽  
Imaging Modality ◽  
Correct Diagnosis ◽  
Clinical History ◽  
Magnetic Resonance Neurography ◽  
Nerve Lesions ◽  
Peripheral Nerve Lesions ◽  
Intraoperative Management ◽  
High Resolution Ultrasonography

Object The diagnosis of peripheral nerve lesions relies on clinical history, physical examination, electrodiagnostic studies, and radiography. Magnetic resonance neurography offers high-resolution visualization of structural peripheral nerve lesions. The availability of MR neurography may be limited, and the costs can be significant. By comparison, ultrasonography is a portable, dynamic, and economic technology. The authors explored the clinical applicability of high-resolution ultrasonography in the preoperative and intraoperative management of peripheral nerve lesions. Methods The authors completed a retrospective analysis of 13 patients undergoing ultrasonographic evaluation and surgical treatment of nerve lesions at their institution (nerve entrapment [5], trauma [6], and tumor [2]). Ultrasonography was used for diagnostic (12 of 13 cases) and intraoperative management (6 of 13 cases). The authors examine the initial impact of ultrasonography on clinical management. Results Ultrasonography was an effective imaging modality that augmented electrophysiological and other neuroimaging studies. The modality provided immediate visualization of a sutured peroneal nerve after a basal cell excision, prompting urgent surgical exploration. Ultrasonography was used intraoperatively in 2 cases to identify postoperative neuromas after mastectomy, facilitating focused excision. Ultrasonography correctly diagnosed an inflamed lymph node in a patient in whom MR imaging studies had detected a schwannoma, and the modality correctly diagnosed a tendinopathy in another patient referred for ulnar neuropathy. Ultrasonography was used in 6 patients to guide the surgical approach and to aid in intraoperative localization; it was invaluable in localizing the proximal segment of a radial nerve sectioned by a humerus fracture. In all cases, ultrasonography demonstrated the correct lesion diagnosis and location (100%); in 7 (58%) of 12 cases, ultrasonography provided the correct diagnosis when other imaging and electrophysiological studies were inconclusive or inadequate. Conclusions High-resolution ultrasonography may provide an economical and accurate imaging modality with utility in diagnosis and management of peripheral nerve lesions. Further research is required to assess the role of ultrasonography in evaluation of peripheral nerve pathology.

Top-Ten Tips for Imaging the Brachial Plexus with Ultrasound and MRI

2019 ◽  
Vol 23 (04) ◽  
pp. 405-418 ◽  
Author(s):  
James F. Griffith ◽  
Radhesh Krishna Lalam
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Brachial Plexus ◽  
Muscle Denervation ◽  
Resonance Imaging ◽  
Neural Injury ◽  
Clinical Indications ◽  
Magnetic Resonance Imaging Mri ◽  
High Level ◽  
Extensive Involvement

AbstractWhen it comes to examining the brachial plexus, ultrasound (US) and magnetic resonance imaging (MRI) are complementary investigations. US is well placed for screening most extraforaminal pathologies, whereas MRI is more sensitive and accurate for specific clinical indications. For example, MRI is probably the preferred technique for assessment of trauma because it enables a thorough evaluation of both the intraspinal and extraspinal elements, although US can depict extraforaminal neural injury with a high level of accuracy. Conversely, US is probably the preferred technique for examination of neurologic amyotrophy because a more extensive involvement beyond the brachial plexus is the norm, although MRI is more sensitive than US for evaluating muscle denervation associated with this entity. With this synergy in mind, this review highlights the tips for examining the brachial plexus with US and MRI.

scholarly journals Effectiveness of low-field magnetic resonance imaging in diagnosing brachial plexus tumours in dogs – short communication

2015 ◽  
Vol 59 (2) ◽  
pp. 317-319
Author(s):  
Zbigniew Adamiak ◽  
Yauheni Zhalniarovich ◽  
Paulina Przyborowska ◽  
Joanna Głodek ◽  
Adam Przeworski
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Brachial Plexus ◽  
Resonance Imaging ◽  
Gadolinium Contrast ◽  
Gadolinium Contrast Agent ◽  
Low Field ◽  
Mri Sequences ◽  
Magnetic Resonance Imaging Mri ◽  
Brachial Plexus Tumours

AbstractThe aim of the study was to identify magnetic resonance imaging (MRI) sequences that contribute to a quick and reliable diagnosis of brachial plexus tumours in dogs. The tumours were successfully diagnosed in 6 dogs by the MRI with the use of SE, FSE, STIR, Turbo 3 D, 3D HYCE, and GE sequences and the gadolinium contrast agent

Compression neuropathies of the forearm: anatomy, clinical features and management

2021 ◽  
pp. 1-10
Author(s):  
Alexander Scarborough ◽  
Robert J MacFarlane ◽  
Michail Klontzas ◽  
Rui Zhou ◽  
Mohammad Waseem
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Upper Limb ◽  
Peripheral Nerves ◽  
Clinical Presentation ◽  
Permanent Damage ◽  
Peripheral Nerve Lesions ◽  
Clinical Presentations ◽  
Wide Range ◽  
Prompt Diagnosis

The upper limb consists of four major parts: a girdle formed by the clavicle and scapula, the arm, the forearm and the hand. Peripheral nerve lesions of the upper limb are divided into lesions of the brachial plexus or the nerves arising from it. Lesions of the nerves arising from the brachial plexus are further divided into upper (proximal) or lower (distal) lesions based on their location. Peripheral nerves in the forearm can be compressed in various locations and by a wide range of pathologies. A thorough understanding of the anatomy and clinical presentations of these compression neuropathies can lead to prompt diagnosis and management, preventing possible permanent damage. This article discusses the aetiology, anatomy, clinical presentation and surgical management of compressive neuropathies of the upper limb.

scholarly journals Occlusal stabilization appliance: evaluation of its efficacy in the treatment of temporomandibular disorders

2004 ◽  
Vol 12 (3) ◽  
pp. 238-243 ◽  
Author(s):  
Elisa Emi Tanaka ◽  
Emiko Saito Arita ◽  
Bunji Shibayama
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Temporomandibular Joint ◽  
Temporomandibular Disorders ◽  
Imaging Modality ◽  
Clinical Status ◽  
Signs And Symptoms ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Evaluation

Occlusal stabilization appliances or splints are the most widely employed method for treatment of temporomandibular disorders (TMD). Magnetic Resonance Imaging (MRI) is the most indicated imaging modality to evaluate the components of the temporomandibular joint (TMJ). Forty patients with signs and symptoms of temporomandibular disorders were treated with splints for a mean period of 12 months, comprising regular semimonthly follow-ups. After stabilization of the clinical status, occlusal adjustments and MRI evaluation were performed. It was concluded that the success of this kind of treatment are related to the total (70%) or partial improvement (22.5%) of painful symptomatology and to the functional reestablishment of the craniomandibular complex. The MRI allowed evaluation and also the conclusion that the splints provide conditions for the organism to develop means to resist to the temporomandibular disorders by means of elimination of several etiologic factors. Moreover, after treatment the patients are able to cope with disc displacements with larger or smaller tolerance.

Fascicular Ratio Pilot Study: High-Resolution Neurosonography—A Possible Tool for Quantitative Assessment of Traumatic Peripheral Nerve Lesions Before and After Nerve Surgery

Neurosurgery ◽  
2018 ◽  
Vol 85 (3) ◽  
pp. 415-422 ◽  
Author(s):  
Christian Heinen ◽  
Patrick Dömer ◽  
Thomas Schmidt ◽  
Bettina Kewitz ◽  
Ulrike Janssen-Bienhold ◽  
...  
Keyword(s):  
High Resolution ◽  
Peripheral Nerve ◽  
Quantitative Assessment ◽  
Control Group ◽  
Structural Reorganization ◽  
Magnetic Resonance Neurography ◽  
Nerve Lesions ◽  
Peripheral Nerve Lesions ◽  
Significant Difference ◽  
Nerve Surgery

Abstract BACKGROUND Clinical and electrophysiological assessments prevail in evaluation of traumatic nerve lesions and their regeneration following nerve surgery in humans. Recently, high-resolution neurosonography (HRNS) and magnetic resonance neurography have gained significant importance in peripheral nerve imaging. The use of the grey-scale-based “fascicular ratio” (FR) was established using both modalities allowing for quantitative assessment. OBJECTIVE To find out whether FR using HRNS can assess nerve trauma and structural reorganization in correlation to postoperative clinical development. METHODS Retrospectively, 16 patients with operated traumatic peripheral nerve lesions were included. The control group consisted of 6 healthy volunteers. All imaging was performed with a 15 to 6 MHz ultrasound probe (SonoSite X-Porte; Fujifilm, Tokyo, Japan). FR was calculated using Fiji (兠) on 8-bit-images (“MaxEntropy” using “Auto-Threshold” plug-in). RESULTS Thirteen of 16 patients required autologous nerve grafting and 3 of 16 extra-intraneural neurolysis. There was no statistical difference between the FR of nonaffected patients’ nerve portion with 43.48% and controls with FR 48.12%. The neuromatous nerve portion in grafted patients differed significantly with 85.05%. Postoperatively, FR values returned to normal with a mean of 39.33%. In the neurolyzed patients, FR in the affected portion was 78.54%. After neurolysis, FR returned to healthy values (50.79%). Ten of 16 patients showed clinical reinnervation. CONCLUSION To our best knowledge, this is the first description of FR using HRNS for quantitative assessment of nerve damage and postoperative structural reorganization. Our results show a significant difference in healthy vs lesioned nerves and a change in recovering nerve portions towards a more “physiological” ratio. Further evaluation in larger patient groups is required.

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