Feasibility of Diffusion Tensor and Morphologic Imaging of Peripheral Nerves at Ultra-High Field Strength

Schmid, Annina B.; Campbell, Jon; Jbabdi, Saâd; Andersson, Jesper; Jenkinson, Mark; Bangerter, Neal K.; Bennett, David L.H.; Tracey, Irene; Frost, Robert; Clare, Stuart

doi:10.1097/rli.0000000000000492

Cited by 15 publications

(39 citation statements)

References 51 publications

(57 reference statements)

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“…Third, there are limited sequences and software developed for imaging the peripheral nerve, making reliable interpretation of PNS difficult. Nevertheless, peripheral nerve MRI has grown recently, and a few potential biomarkers have been reported in various studies in patients with peripheral neuropathies 17, 19, 21, 24, 25, 28, 31– 33 .…”

Section: Peripheral Nerve Magnetic Resonance Imagingmentioning

confidence: 99%

Peripheral nerve magnetic resonance imaging

Chen

Haacke

2019

F1000Res

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Magnetic resonance imaging (MRI) has been used extensively in revealing pathological changes in the central nervous system. However, to date, MRI is very much underutilized in evaluating the peripheral nervous system (PNS). This underutilization is generally due to two perceived weaknesses in MRI: first, the need for very high resolution to image the small structures within the peripheral nerves to visualize morphological changes; second, the lack of normative data in MRI of the PNS and this makes reliable interpretation of the data difficult. This article reviews current state-of-the-art capabilities in in vivo MRI of human peripheral nerves. It aims to identify areas where progress has been made and those that still require further improvement. In particular, with many new therapies on the horizon, this review addresses how MRI can be used to provide non-invasive and objective biomarkers in the evaluation of peripheral neuropathies. Although a number of techniques are available in diagnosing and tracking pathologies in the PNS, those techniques typically target the distal peripheral nerves, and distal nerves may be completely degenerated during the patient’s first clinic visit. These techniques may also not be able to access the proximal nerves deeply embedded in the tissue. Peripheral nerve MRI would be an alternative to circumvent these problems. In order to address the pressing clinical needs, this review closes with a clinical protocol at 3T that will allow high-resolution, high-contrast, quantitative MRI of the proximal peripheral nerves.

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Section: Peripheral Nerve Magnetic Resonance Imagingmentioning

confidence: 99%

Peripheral nerve magnetic resonance imaging

Chen

Haacke

2019

F1000Res

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“…Four authors provided additional information upon request. [16][17][18][19] When no reply was received, estimates were derived from graphs or imputed where possible. 20…”

Section: Data Extractionmentioning

confidence: 99%

“…Ten studies (32%) were performed at a eld strength of 1•5 tesla 17,29,32,35,38,42,44,49,50,52 , twenty one (65%) at 3 tesla 16,19,[26][27][28]30,31,33,34,36,37,[39][40][41]43,[45][46][47][48]51,53 , and one at 7 tesla 18 . The median echo and repetition times were 87ms (IQR 65-91, range 21-103) and 7000ms (IQR 3800-7650, range 1470-10,254), respectively.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Two studies used read-out segment echo-planar imaging (rsEPI) 33,45 , two did not specify the pulse sequence 19,48 and the remainder used single-shot echo-planar imaging (ssEPI). Twelve studies described using the parallel imaging techniques (GRAPPA 18,27,41 , SENSE 17,28,31,38,40,45,51 and CAIPIRINHA 30 ) and six studies used partial Fourier transformations 30,32,34,38,40,43,45 . The median slice thickness was 3•5mm (IQR 2•6-4•0mm, range 1•5-5mm).…”

Section: Study Characteristicsmentioning

confidence: 99%

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Diffusion Tensor Imaging of the Median Nerve: A Systematic Review and Meta-Analysis of Normal Values in Asymptomatic Adults and How They Change in Carpal Tunnel Syndrome

Rojoa

Raheman

Rassam

et al. 2021

Preprint

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Background: Carpal tunnel syndrome (CTS) leads to distortion of axonal architecture, demyelination and fibrosis within the median nerve. Diffusion tensor imaging (DTI) characterises tissue microstructure and generates reproducible proxy measures of nerve ‘health’ which are sensitive to myelination, axon diameter, fibre density and organisation. This meta-analysis summarises the normal DTI values of the median nerve, and how they change in CTS.Methods: This systematic review included studies reporting DTI of the median nerve at the level of the wrist in adults. The primary outcome was to determine the normal fractional anisotropy (FA) and mean diffusivity (MD) of the median nerve. Secondarily, we show how the FA and MD differ between asymptomatic adults and patients with CTS, and how these differences are independent of the acquisition methods.Results: 32 studies of 2643 wrists, belonging to 1575 asymptomatic adults and 1068 patients with CTS were included. The normal FA was 0·58 (95% CI 0·56, 0·59) and the normal MD was 1·138 x10-3 mm2/s (95% CI 1·101, 1·174). Patients with CTS had a significantly lower FA than controls (mean difference 0·12 [95% CI 0·09, 0·16]). Similarly, the median nerve of patients with CTS had a significantly higher mean diffusivity (mean difference 0·16 mm2/s x10-3 [95% CI 0·05, 0·27]). The differences were independent of experimental factors.Conclusion: We provide summary estimates of the normal FA and MD of the median nerve in asymptomatic adults. Furthermore, we show that diffusion throughout the length of the median nerve becomes more isotropic in patients with CTS.

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“…Its technological advancements and novel sequences allow investigating ever smaller structures with striking anatomical detail. [1][2][3][4] Nevertheless, ultrasound has well-established advantages, able to examine very small structures and provide high-resolution images with a quick and real-time dynamic evaluation and the possibility of easily making a comparison with the contralateral side. [5][6][7][8] For these reasons, ultrasound has kept its own almost exclusive fields of application in daily clinical practice, and it is considered the top imaging choice to assess tendons, bursae, and capsuloligamentous structures of small peripheral joints and nerves.…”

mentioning

confidence: 99%

High-Frequency and Ultra-High Frequency Ultrasound: Musculoskeletal Imaging up to 70 MHz

Albano

Aringhieri

Messina

et al. 2020

Semin Musculoskelet Radiol

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Musculoskeletal (MSK) ultrasound has well-established advantages, able to investigate very small structures with high resolution and a quick and real-time dynamic evaluation with the possibility of contralateral comparison. Thus ultrasound has kept its own almost exclusive fields of application in daily clinical practice, and it is considered the first-level imaging technique to assess tendons, bursae, and capsuloligamentous structures of small peripheral joints as well as peripheral nerves. Up to now, however, clinical MSK ultrasound imaging could not go beyond the first 1 to 2 cm under the skin, using high-frequency probes up to 18 to 20 MHz with spatial resolution just below millimeters. We present the impressive technical advancements leading to image resolution as low as 30 µm using ultra-high frequency ultrasound (UHFUS) probes up to 70 MHz. High-frequency ultrasound and UHFUS, with frequencies ranging from 22 to 70 MHz, are promising tools to evaluate very superficial structures. In the MSK system, only two articles have assessed its value in limited case series. Future developments may be aimed to better assess ultrastructural changes of very superficial peripheral nerves and other thin structures such as pulleys, retinacula, and tendons.

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Feasibility of Diffusion Tensor and Morphologic Imaging of Peripheral Nerves at Ultra-High Field Strength

Abstract: Supplemental digital content is available in the text.

Cited by 15 publications

References 51 publications

Peripheral nerve magnetic resonance imaging

Peripheral nerve magnetic resonance imaging

Diffusion Tensor Imaging of the Median Nerve: A Systematic Review and Meta-Analysis of Normal Values in Asymptomatic Adults and How They Change in Carpal Tunnel Syndrome

High-Frequency and Ultra-High Frequency Ultrasound: Musculoskeletal Imaging up to 70 MHz

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