Quantitative Evaluation and Visualization of Lumbar Foraminal Nerve Root Entrapment by Using Diffusion Tensor Imaging: Preliminary Results

Eguchi, Yawara; Ohtori, Seiji; Orita, Sumihisa; Kamoda, Hiroto; Arai, Gen; Ishikawa, Tetsuhiro; Miyagi, Masayuki; Inoue, Gen; Suzuki, Mitsuaki; Masuda, Yoshitada; Andou, H.; Takaso, Masashi; Aoki, Yasuchika; Toyone, Tomoaki; Watanabe, Atsuya; Takahashi, Kazuhisa

doi:10.3174/ajnr.a2681

Cited by 91 publications

(82 citation statements)

References 34 publications

(45 reference statements)

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“…25,26 Thus, we applied a single ROI technique for the fibre tracking, in common with other previous studies on DTI of the peripheral nerves. 12,15,19 Our study had several limitations. First, our case series involved only healthy volunteers, and their age group was relatively young.…”

Section: Discussionmentioning

confidence: 99%

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Diffusion tensor imaging of the inferior alveolar nerve using 3T MRI: a study for quantitative evaluation and fibre tracking

Kotaki¹,

Sakamoto²,

Kretapirom³

et al. 2016

Dentomaxillofacial Radiology

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Objectives: Diffusion tensor imaging (DTI) can provide structural information and objective values for nerves. The aims of this study were to perform quantitative evaluation and fibre tracking of the normal inferior alveolar nerve (IAN) using DTI on 3.0-T MRI. Methods: DTI was applied to 92 IANs of 46 healthy volunteers. Circular regions of interest (ROIs) were placed on three different positions at the mandibular foramen, second molar and mental foramen of each nerve on apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps, and the ADC and FA of each ROI were measured. Differences in the values arising from the nerve positions were evaluated. Furthermore, fibre tracking of the IANs was performed by tractography, and the quality of visualization was evaluated. Results: There were no significant differences in the ADC and FA between the right and left sides regardless of the anteroposterior positions. Regarding differences arising from the anteroposterior measurement positions, the ADC and FA showed no significant differences (p . 0.017), except for the ADCs between the positions at the mandibular foramen and mental foramen in the left side (p 5 0.0068). Overall, 70 (76%) of the 92 IANs could be visualized fully or partially by tractography. Conclusions: The ADC and FA of the IAN were successfully obtained from healthy volunteers using DTI and were confirmed to be symmetrical regardless of the measurement positions. DTI is a feasible technique for the quantitative evaluation and visualization of the IAN.

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Section: Discussionmentioning

confidence: 99%

“…Recently, this technique has also been applied to several peripheral nerves, namely the median nerve, 12 tibial nerve 13,14 and lumbar plexus. 15 Those studies demonstrated that the ADC and FA could reflect the pathological conditions of peripheral nerves. To date, only a few studies reported the application of DTI to the IAN.…”

Section: Introductionmentioning

confidence: 99%

Diffusion tensor imaging of the inferior alveolar nerve using 3T MRI: a study for quantitative evaluation and fibre tracking

Kotaki¹,

Sakamoto²,

Kretapirom³

et al. 2016

Dentomaxillofacial Radiology

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“…A total of 683 subjects were studied across 24 DTI articles. 177 patients with lumbar spinal canal stenosis (LSCS) in 5 articles 11,12,16,17,20) , 143 patients with lumbar disc herniation (LDH) in 7 articles 7,13,15,20,21,23,29) , 112 patients with lumbar radiculopathy in 3 articles 10,19,22) , 36 patients with foraminal stenosis (FS) in 6 articles 9,11,16,20,27,28) , 2 patients with lower back pain in one article 20) , 3 cases with diastematomyelia and one case with tethered cord in one article 30) , and one case with spina bifida in one article 26) were included. 7 post mortem subjects were investigated in one article 8) .…”

Section: Diffusion-weighted Mr Neurographymentioning

confidence: 99%

“…7 post mortem subjects were investigated in one article 8) . 201 healthy volunteers were also investigated in 15 articles 8,11,14,[16][17][18][19][22][23][24][25][26][28][29][30] .…”

Section: Diffusion-weighted Mr Neurographymentioning

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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Clinical Value and Reliability of Quantitative Assessments of Lumbosacral Nerve Root Using Diffusion Tensor and Diffusion Weighted MR Imaging: A Systematic Review

Pesesse,

Vanderthommen,

Durieux

et al. 2024

Magnetic Resonance Imaging

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BackgroundLumbosacral radicular pain diagnosis remains challenging. Diffusion tensor imaging (DTI) and diffusion weighted imaging (DWI) have potential to quantitatively evaluate symptomatic nerve root, which may facilitate diagnosis.PurposeTo determine the ability of DTI and DWI metrics, namely fractional anisotropy (FA) and apparent diffusion coefficient (ADC), to discriminate between healthy and symptomatic lumbosacral nerve roots, to evaluate the association between FA and ADC values and patient symptoms, and to determine FA and ADC reliability.Study TypeSystematic review.SubjectsEight hundred twelve patients with radicular pain with or without radiculopathy caused by musculoskeletal‐related compression or inflammation of a single, unilateral lumbosacral nerve root and 244 healthy controls from 29 studies.Field Strength/SequenceDiffusion weighted echo planar imaging sequence at 1.5 T or 3 T.AssessmentAn extensive systematic review of the literature was conducted in Embase, Scopus, and Medline databases. FA and ADC values in symptomatic and contralateral lumbosacral nerve roots were extracted and summarized, together with intra‐ and inter‐rater agreements. Where available, associations between DWI or DTI parameters and patient symptoms or symptom duration were extracted.Statistical TestsThe main results of the included studies are summarized. No additional statistical analyses were performed.ResultsThe DTI studies systematically found significant differences in FA values between the symptomatic and contralateral lumbosacral nerve root of patients suffering from radicular pain with or without radiculopathy. In contrast, identification of the symptomatic nerve root with ADC values was inconsistent for both DTI and DWI studies. FA values were moderately to strongly correlated with several symptoms (eg, disability, nerve dysfunction, and symptom duration). The inter‐ and intra‐rater reliability of DTI parameters were moderate to excellent. The methodological quality of included studies was very heterogeneous.Data ConclusionThis systematic review showed that DTI was a reliable and discriminative imaging technique for the assessment of symptomatic lumbosacral nerve root, which more consistently identified the symptomatic nerve root than DWI. Further studies of high quality are needed to confirm these results.Evidence LevelN/ATechnical EfficacyStage 2

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Quantitative Evaluation and Visualization of Lumbar Foraminal Nerve Root Entrapment by Using Diffusion Tensor Imaging: Preliminary Results

Cited by 91 publications

References 34 publications

Diffusion tensor imaging of the inferior alveolar nerve using 3T MRI: a study for quantitative evaluation and fibre tracking

Diffusion tensor imaging of the inferior alveolar nerve using 3T MRI: a study for quantitative evaluation and fibre tracking

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

Clinical Value and Reliability of Quantitative Assessments of Lumbosacral Nerve Root Using Diffusion Tensor and Diffusion Weighted MR Imaging: A Systematic Review

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