Diffusion Tensor Imaging Adds Diagnostic Accuracy in Magnetic Resonance Neurography

Breckwoldt, Michael O.; Stock, Christian; Xia, Annie; Heckel, A.; Bendszus, Martin; Pham, Mirko; Heiland, Sabine; Bäumer, Philipp

doi:10.1097/rli.0000000000000156

Cited by 70 publications

(73 citation statements)

References 34 publications

(41 reference statements)

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“…First, no combination with diffusion imaging was established, which might have enhanced correct identification of nerves and accuracy, as suggested by investigations on peripheral nerve pathologies [18]. Second, we only enrolled healthy subjects in this study to establish a new quantitative MRN approach and to provide normative T2 values for clinical purposes; therefore, it has to be evaluated in further studies whether patients with lesions of LSP nerves show significantly altered measurements when compared to data derived from healthy subjects.…”

Section: Discussionmentioning

confidence: 99%

High Isotropic Resolution T2 Mapping of the Lumbosacral Plexus with T2-Prepared 3D Turbo Spin Echo

et al. 2018

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Purpose Isotropic high-resolution three-dimensional (3D) magnetic resonance neurography (MRN) is increasingly used to depict even small and highly oblique nerves of the lumbosacral plexus (LSP). The present study introduces a T2 mapping sequence (T2-prepared 3D turbo spin echo) that is B1-insensitive and enables quantitative assessment of LSP nerves. Methods In this study 15 healthy subjects (mean age 28.5 ± 3.8 years) underwent 3 T MRN of the LSP area three times. The T2 values were calculated offline on a voxel-by-voxel basis and measured at three segments (preganglionic, ganglionic, postganglionic) of three LSP nerves (S1, L5, L4) by two independent investigators (experienced and novice). Normative data for the different nerves were extracted and intraclass correlation coefficients (ICCs) were calculated to assess reproducibility and interobserver reliability of T2 measurements. Results The T2 mapping showed excellent reproducibility with ICCs ranging between 0.99 (S1 preganglionic) and 0.89 (L5 postganglionic). Interobserver reliability was less robust with ICCs ranging between 0.78 (S1 preganglionic) and 0.44 (L5 postganglionic) for S1 and L5. A mean T2 value of 74.6 ± 4.7 ms was registered for preganglionic segments, 84.7 ± 4.1 ms for ganglionic and 65.4 ± 2.5 ms for postganglionic segments, respectively. There was a statistically significant variation of T2 values across the nerve (preganglionic vs ganglionic vs postganglionic) for S1, L5, and L4. Conclusion Our approach enables isotropic high-resolution and B1-insensitive T2 mapping of LSP nerves with excellent reproducibility. It might reflect a robust and clinically useful method for future diagnostics of LSP pathologies.

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Section: Discussionmentioning

confidence: 99%

High Isotropic Resolution T2 Mapping of the Lumbosacral Plexus with T2-Prepared 3D Turbo Spin Echo

et al. 2018

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“…136 As an additional functional technique, DTI is increasingly being investigated with regard to its potential to help detect nerve injury and monitor reinnervation. 137–140 More recent work has shown that DTI can be used for diagnosis of neuropathy, 141 as well as bring new insights into the involvement of central nervous system in DPN.…”

Section: Non-invasive Mri Techniques To Assess Dpn Featuresmentioning

confidence: 99%

Declining Skeletal Muscle Function in Diabetic Peripheral Neuropathy

Parasoglou

Rao

Slade

2017

Clinical Therapeutics

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Purpose In this review, we highlight the current concepts in the effects of diabetic peripheral neuropathy (DPN) in skeletal muscle. We discuss the lack of effective pharmacological treatments and the role of physical exercise intervention in limb protection and symptom reversal. We also highlight the importance of Magnetic Resonance Imaging (MRI) techniques in providing a mechanistic understanding of the disease and helping develop targeted treatments. Methods This review provides a comprehensive reporting on the effects of DPN in the skeletal muscle of diabetic patients. It also provides an update on the most recent trials of exercise intervention targeting DPN pathology. Lastly, we report on emerging MRI techniques that have shown promise in providing a mechanistic understanding of DPN and can help improve the design and implementation of clinical trials in the future. Findings Impairments in lower limb muscles reduce functional capacity and contribute to altered gait, increased fall risk, and impaired balance in patients with DPN. This is an important concern for DPN patients as their falls are very likely to be injurious, and lead to bone fractures, poorly healing wounds, and chronic infections that may require amputation. Preliminary studies have shown that moderate intensity exercise programs are well tolerated by patients with DPN. They can improve their cardiorespiratory function and can partially reverse some of the DPN symptoms. MRI has the potential to bring new mechanistic insights into the effects of DPN as well as to objectively measure small changes in DPN pathology as a result of intervention. Implications Non-invasive exercise intervention is particularly valuable in DPN due to its safety, low cost, and potential to augment pharmacological interventions. As we gain a better mechanistic understanding of the disease, more targeted and effective interventions can be designed.

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“…FA values are associated with the nerve development and brain functions [18][19][20]. The FA change rate could be a biomarker to monitor the brain development.…”

Section: Discussionmentioning

confidence: 99%

Monitoring fractional anisotropy in developing rabbit brain using MR diffusion tensor imaging at 3T

et al. 2016

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The aim of this study was to investigate the factional anisotropy (FA) in various regions of developing rabbit brain using magnetic resonance diffusion tensor imaging (MR DTI) at 3 T. A whole-body clinical MR imaging (MRI) scanner with a 15-channel high resolution knee coil was used. An echo-planar-imaging (EPI)-DTI pulse sequence was performed. Five 5 week-old New Zealand white (NZW) rabbits underwent MRI once per week for 24 weeks. After scanning, FA maps were obtained. ROIs (regions of interests) in the frontal lobe, parietal & temporal lobe, and occipital lobe were measured. FA changes with time were evaluated with a linear regression analysis. The results show that the FA values in all lobes of the brain increased linearly with age. The ranking of FA values was FA(frontal lobe) > FA(parietal & temporal lobe) > FA(occipital lobe). There was significant difference (p < 0.05) among these lobes. FA values are associated with the nerve development and brain functions. The FA change rate could be a biomarker to monitor the brain development. Understanding the FA values of various lobes during development could provide helpful information to diagnosis the abnormal syndrome earlier and have a better treatment and prognosis. This study established a brain MR-DTI protocol for rabbits to investigate the brain anatomy during development using clinical MRI. This technique can be further applied to the pre-clinical diagnosis, treatment, prognosis and follow-up of brain lesions.

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Diffusion Tensor Imaging Adds Diagnostic Accuracy in Magnetic Resonance Neurography

Abstract: Diffusion tensor imaging has high diagnostic accuracy in peripheral neuropathy. Combining DTI with T2 can outperform T2-w imaging alone and provides added value in magnetic resonance neurography.

Cited by 70 publications

References 34 publications

High Isotropic Resolution T2 Mapping of the Lumbosacral Plexus with T2-Prepared 3D Turbo Spin Echo

High Isotropic Resolution T2 Mapping of the Lumbosacral Plexus with T2-Prepared 3D Turbo Spin Echo

Declining Skeletal Muscle Function in Diabetic Peripheral Neuropathy

Monitoring fractional anisotropy in developing rabbit brain using MR diffusion tensor imaging at 3T

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