Diffusion-weighted magnetic resonance imaging of symptomatic nerve root of patients with lumbar disk herniation

Eguchi, Yawara; Ohtori, Seiji; Yamashita, Masaomi; Yamauchi, Kazuyo; Suzuki, Mitsuaki; Orita, Sumihisa; Kamoda, Hiroto; Arai, Gen; Ishikawa, Tetsuhiro; Miyagi, Masayuki; Ochiai, Nobuyasu; Kishida, Shunji; Inoue, Gen; Masuda, Yoshitada; Ochi, Shigehiro; Kikawa, Takashi; Toyone, Tomoaki; Takaso, Masashi; Aoki, Yasuchika; Takahashi, Kazuhisa

doi:10.1007/s00234-010-0801-7

Cited by 43 publications

(41 citation statements)

References 32 publications

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“…2A) demonstrated the feasibility of whole-body MR neurography with DWI that can visualize tissues with impeded diffusion, such as tumors, the brain, the spinal cord, and the peripheral nerves 56) . We found that diffusion-weighted MR neurography revealed that nerve swelling and transverse and mean ADC values were significantly greater in entrapped nerve roots in patients with lumbar disc herniation 39) and lumbar foraminal stenosis (Fig. 2B, C) 40) , suggesting demyelination and edema by slow compression caused by an increased degree of diffusion compared with that of normal tissue.…”

Section: Diffusion-weighted Mr Neurographymentioning

confidence: 81%

“…We excluded reviews, spinal cord studies and animal or in vivo studies. Our review identified a total of 35 articles: 24 DTI studies and 11 diffusionweighted MR neurography studies [31][32][33][34][35][36][37][38][39][40][41] . The number of lumbar nerve DTI studies has sharply increased in recent years ( Fig.…”

Section: Trends In Clinical Mr Neuroimaging Of Lumbar Nervesmentioning

confidence: 99%

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Recent advances in magnetic resonance neuroimaging of lumbar nerve to clinical applications: A review of clinical studies utilizing Dffusion Tensor Imaging and Diffusion-weighted magnetic resonance neurography

Eguchi

Kanamoto

Oikawa³

et al. 2017

Spine Surg Relat Res

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Abstract:Much progress has been made in neuroimaging with Magnetic Resonance neurography and Diffusion Tensor Imaging (DTI) owing to higher magnetic fields and improvements in pulse sequence technology. Reports on lumbar nerve DTI have also increased considerably.Many studies have shown that the use of DTI in lumbar nerve lesions, such as lumbar foraminal stenosis and lumbar disc herniation, makes it possible to capture images of interruptions of tractography at stenotic sties, enabling the diagnosis of stenosis. DTI can also reveal significant decreases in fractional anisotropy (FA) with significant increases in apparent diffusion coefficient (ADC) values in compression lesions.FA values have higher accuracy than ADC values. Furthermore, strong correlations exist between FA values and indications of neurological severity, including the Japanese Orthopedic Association (JOA) score, the Oswestry Disability Index (ODI), and the Roland-Morris Disability Questionnaire (RDQ) in patients with lumbar disc herniation-induced radiculopathy.Most lumbar DTI has become 3T; 3T MRI has made it possible to take high-resolution DTI measurements in a short period of time. However, increased motion artifacts in the magnetic susceptibility effect lead to signal irregularities and image distortion. In the future, high-resolution DTI with reduced field-of-view may become useful in clinical applications, since visualization of nerve lesions and quantification of DTI parameters could allow more accurate diagnoses of lumbar nerve dysfunctions. Future translational studies will be necessary to successfully bring MR neuroimaging of lumbar nerve into clinical use.

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Section: Diffusion-weighted Mr Neurographymentioning

confidence: 81%

Section: Trends In Clinical Mr Neuroimaging Of Lumbar Nervesmentioning

confidence: 99%

Recent advances in magnetic resonance neuroimaging of lumbar nerve to clinical applications: A review of clinical studies utilizing Dffusion Tensor Imaging and Diffusion-weighted magnetic resonance neurography

Eguchi

Kanamoto

Oikawa³

et al. 2017

Spine Surg Relat Res

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“…Previous studies reported the common presence of neural oedema/ inflammation surrounding compromised nerve roots both in animals 38 and human beings. 39,40 In human beings, the location of the swollen lumbar nerve root corresponded with the pain locations indicated in pain drawings from patients with sciatica. 39 Therefore, researchers and clinicians have geared their management strategies towards therapeutic injections, 41,42 low velocity mobilisations, and high velocity thrust manipulative therapies, 43,44 all aimed at reducing LBP and nerve root irritation.…”

Section: Quantitative Findingsmentioning

confidence: 85%

Effects of lower limb neurodynamic mobilization on intraneural fluid dispersion of the fourth lumbar nerve root: an unembalmed cadaveric investigation

Gilbert

Smith

Sobczak

et al. 2015

Journal of Manual & Manipulative Therapy

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Objectives: Manual and physical therapists incorporate neurodynamic mobilisation (NDM) to improve function and decrease pain. Little is known about the mechanisms by which these interventions affect neural tissue. The objective of this research was to assess the effects of repetitive straight leg raise (SLR) NDM on the fluid dynamics within the fourth lumbar nerve root in unembalmed cadavers. Methods: A biomimetic solution (Toluidine Blue Stock 1% and Plasma) was injected intraneurally, deep to the epineurium, into the L4 nerve roots of seven unembalmed cadavers. The initial dye spread was allowed to stabilise and measured with a digital calliper. Once the initial longitudinal dye spread stabilised, an intervention strategy (repetitive SLR) was applied incorporating NDMs (stretch/relax cycles) at a rate of 30 repetitions per minute for 5 minutes. Post-intervention calliper measurements of the longitudinal dye spread were measured. Results: The mean experimental posttest longitudinal dye spread measurement (1.1 ± 0.9 mm) was significantly greater (P = 0.02) than the initial stabilised pretest longitudinal dye spread measurement. Increases ranged from 0.0 to 2.6 mm and represented an average of 7.9% and up to an 18.1% increase in longitudinal dye spread. Discussion: Passive NDM in the form of repetitive SLR induced a significant increase in longitudinal fluid dispersion in the L4 nerve root of human cadaveric specimen. Lower limb NDM may be beneficial in promoting nerve function by limiting or altering intraneural fluid accumulation within the nerve root, thus preventing the adverse effects of intraneural oedema.

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“…An increase in ADC and a significant decrease in FA of compressed nerve roots compared with contralateral ones are detected in cases of symptomatic lumbar disk disease. This increase of ADC values is secondary to the venous congestion and edema that occurs in both pre-ganglionic and ganglionic segments of nerve lumbar roots (41). The decrease of FA values is also related to a loss of fiber anisotropy (Figure 11).…”

Section: A B D Cmentioning

confidence: 99%

“…Most clinical studies with DWN have been performed on brachial and lumbar plexus (17,41). In brachial plexus, DWN and DTN have demonstrated their ability to evaluate degenerative, compressive and traumatic conditions (42,43).…”

Section: Plexus Evaluation and Degenerative Disk Nerve Roots Entrapmementioning

confidence: 99%

Quantitative magnetic resonance (MR) neurography for evaluation of peripheral nerves and plexus injuries

Noguerol¹,

Barousse²,

Socolovsky

et al. 2017

Quant. Imaging Med. Surg.

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Traumatic conditions of peripheral nerves and plexus have been classically evaluated by morphological imaging techniques and electrophysiological tests. New magnetic resonance imaging (MRI) studies based on 3D fat-suppressed techniques are providing high accuracy for peripheral nerve injury evaluation from a qualitative point of view. However, these techniques do not provide quantitative information. Diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) are functional MRI techniques that are able to evaluate and quantify the movement of water molecules within different biological structures. These techniques have been successfully applied in other anatomical areas, especially in the assessment of central nervous system, and now are being imported, with promising results for peripheral nerve and plexus evaluation. DWI and DTI allow performing a qualitative and quantitative peripheral nerve analysis, providing valuable pathophysiological information about functional integrity of these structures.In the field of trauma and peripheral nerve or plexus injury, several derived parameters from DWI and DTI studies such as apparent diffusion coefficient (ADC) or fractional anisotropy (FA) among others, can be used as potential biomarkers of neural damage providing information about fiber organization, axonal flow or myelin integrity. A proper knowledge of physical basis of these techniques and their limitations is important for an optimal interpretation of the imaging findings and derived data. In this paper, a comprehensive review of the potential applications of DWI and DTI neurographic studies is performed with a focus on traumatic conditions, including main nerve entrapment syndromes in both peripheral nerves and brachial or lumbar plexus.

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Diffusion-weighted magnetic resonance imaging of symptomatic nerve root of patients with lumbar disk herniation

Abstract: DWI is a potential tool for analysis of the pathophysiology of lumbar nerve roots compressed by herniated disks.

Cited by 43 publications

References 32 publications

Recent advances in magnetic resonance neuroimaging of lumbar nerve to clinical applications: A review of clinical studies utilizing Dffusion Tensor Imaging and Diffusion-weighted magnetic resonance neurography

Recent advances in magnetic resonance neuroimaging of lumbar nerve to clinical applications: A review of clinical studies utilizing Dffusion Tensor Imaging and Diffusion-weighted magnetic resonance neurography

Effects of lower limb neurodynamic mobilization on intraneural fluid dispersion of the fourth lumbar nerve root: an unembalmed cadaveric investigation

Quantitative magnetic resonance (MR) neurography for evaluation of peripheral nerves and plexus injuries

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