Diffusion tensor imaging MR neurography in patients with acute or chronic plexopathy

Case report: A quantitative and qualitative diffusion tensor imaging (DTI) study in varicella zoster-related brachial plexopathy

“…In recent times, DTI has gained attention due to its unmatched ability to generate maps of neural pathways (qualitative approach) and provide objective proxy measures of nerve integrity (quantitative approach) (Righini et al, 2005 ; Wade et al, 2020a ). DTI can differentiate healthy from acute and chronic neuropathy, but the complex geometry of the brachial plexus may be assessed only by considering anatomical notions such as fiber orientation within each emerging nerve, as well as data acquisition and pre- and post-processing approaches (Herweh et al, 2007 ; Hodel et al, 2011 , 2022 ; Crim and Ingalls, 2017 ; Wade et al, 2020b ; van Rosmalen et al, 2021 ). Indeed, the principal eigenvector of the tensor might not represent the actual fiber orientation(s) and therefore it might generate both qualitative and quantitative errors anywhere along the fiber path (Chung et al, 2013 ; van Rosmalen et al, 2021 ).…”

“…Although diffusion tensor imaging (DTI) has been widely applied to the study of the brain microstructure, its usefulness for peripheral nervous system pathology is a more recent acquisition (Hodel et al, 2011 , 2022 ; Chhabra et al, 2013 ; Wade et al, 2020a , b ). DTI is based on the principle that water molecules tend to diffuse more freely along the direction of axonal fascicles rather than across them.…”