Role of magnetic resonance imaging in entrapment and compressive neuropathy—what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 2. Upper extremity

Abstract

The diagnosis of nerve entrapment and compressive neuropathy has been traditionally based on the clinical and electrodiagnostic examinations. As a result of improvements in the magnetic resonance (MR) imaging modality, it plays not only a fundamental role in the detection of space-occupying lesions, but also a compensatory role in clinically and electrodiagnostically inconclusive cases. Although ultrasound has undergone further development in the past decades and shows high resolution capabilities, it has inherent limitations due to its operator dependency. We review the course of normal peripheral nerves, as well as various clinical demonstrations and pathological features of compressed and entrapped nerves in the upper extremities on MR imaging, according to the nerves involved. The common sites of nerve entrapment of the upper extremity are as follows: the brachial plexus of the thoracic outlet; axillary nerve of the quadrilateral space; radial nerve of the radial tunnel; ulnar nerve of the cubital tunnel and Guyon's canal; median nerve of the pronator syndrome, anterior interosseous nerve syndrome, and carpal tunnel syndrome. Although MR imaging can depict the peripheral nerves in the extremities effectively, radiologists should be familiar with nerve pathways, common sites of nerve compression, and common space-occupying lesions resulting in nerve compression in MR imaging.

Analysis of MR Imaging of Wrists in Female Patients with Carpal Tunnel Syndrome and Healthy Controls

“…Our MRI protocols mainly focused on the assesment of morphologic anatomy of carpal tunnel and do not include functional MRI techniques. As we see the literature with regard to MRI of upper extremity peripheral neuropathies, most publications are also focused on the morphological appearance of those neuropathies (Jarvik et al, 2004;Beltran & Rosenberg, 1994;Kim et al;Spinner & Amadio, 2003;Spratt et al).…”

“…In most of the patients suffer severely a pain from the etiology of the underlying nerve injury (Andreisek et al, 2008). Recently, most studies have pointed that MRI findings in various areas with related to median nerve and other peripheral nerves disorders in upper extremity peripheral neuropathies (Andreisek et al; Kim et al, 2007;Grant et al, 2001;Taussaint et al, 2008;Hof et al, 2008;Amrami et al, 2008).…”

“…Many authors have used to different visualization technics to demonstrate median nerve in carpal tunnel such as MRI (Kim et al;Deryani et al, 2003;Grant et al;Bone´l et al, 2001;Keberle et al, 2000;Monagle et al, 1999;Kleindienst et al, 1998;Amrami et al;Brahme et al, 1997;Allmann et al, 1997;Sugimoto et al, 1994;Andreisek et al), diffusion tensor imaging and tractography, and sonography with compare to MR and CT scans (Buchberger et al, 1992;Propeck et al, 2000).…”

Tuzak nöropatilerde manyetik rezonans görüntüleme

“…İskemi uzadıkça, ödem yerini fibrozise bırakır (Şekil 26). [38] Üst ekstremitenin en sık karşımıza çıkan tuzak nöro-patisi olup, orta yaş kadın hastalarda sıktır. Diyabet, romatoid artrit, gut, kalsiyum pirofosfat depolanması, amiloid depolanması, akromegali, gebelik, hipotiroidizm, kitleler (gangliyon kisti, lipom vb.…”

El examen de seis músculos individuales: ¿puede representar un enfoque diagnóstico de trastornos neuropáticos de los miembros superiores?

“…Las limitaciones comparables se aplican a los estudios de imagen. Mientras los nervios y anomalías circundantes pueden visualizarse 27 , la precisión con respecto a la detección de, por ejemplo, atrapamiento de nervios por ultrasonido e imágenes por resonancia magnética sigue siendo desconocida. Esto se debe a que el resultado de la imagen se comparó con estándares, tales como hallazgos quirúrgicos o electrofisilogía 28 que no sirven como estimaciones válidas para estas condiciones.…”