Technical Update on MR Neurography

Abstract

Imaging evaluation of peripheral nerves (PNs) is challenging. Magnetic resonance imaging (MRI) and ultrasonography are the modalities of choice in the imaging assessment of PNs. Both conventional MRI pulse sequences and advanced techniques have important roles. Routine MR sequences are the workhorse, with the main goal to provide superb anatomical definition and identify focal or diffuse nerve T2 signal abnormalities. Selective techniques, such as three-dimensional (3D) cranial nerve imaging (CRANI) or 3D NerveVIEW, allow for a more detailed evaluation of normal and pathologic states. These conventional pulse sequences have a limited role in the comprehensive assessment of pathophysiologic and ultrastructural abnormalities of PNs. Advanced functional MR neurography sequences, such as diffusion tensor imaging tractography or T2 mapping, provide useful and robust quantitative parameters that can be useful in the assessment of PNs on a microscopic level. This article offers an overview of various technical parameters, pulse sequences, and protocols available in the imaging of PNs and provides tips on avoiding potential pitfalls.

Management of Spontaneous Spinal CSF Leaks Using Noninvasive Dynamic MR Neurography: A Case Series

“…3D nerve isotropic imaging method allows for reformats in any plane (including oblique) with no loss of resolution, hence improving visualization of spinal nerves and leak sites. 17 Till date there is no literature explaining role of MR neurogram for detecting spontaneous spinal CSF leak. However, both MR myelography and CT myelography are well known in detecting and localizing spinal CSF leaks.…”

“…Though dynamic MR neurography can be performed at any center having access to advanced pulse sequences, selective MRI sequence techniques like 3D nerve view also have their own set of pitfalls and artefacts. 17 Reporting dynamic MR Neurography requires a highly trained radiologist with good clinical experience in the reading the MRI sequence as well as detecting SIH.…”

Peripheral nerve traction injury. Literature review

“…У разі ушко д ження периф еричног о нерва ендоневральна рідина може витікати в навколишні тканини. Цей процес можна виявити за допомогою магнітно-резонансної нейрографії, що допомагає визначити місцезнаходження ушкоджень периферичних нервів [20]. Ендоневрій утворений з ендоневральних клітин.…”

Traumatic brachial plexus injury: diagnosis and treatment

“…MR neurography allows for greater soft tissue resolution and the ability to image the spinal cord and postganglionic brachial plexus. Recent advancements in MR sequencing have decreased CSF pulsation artifacts and provided better spatial resolution (Figure 2c,d) [11,12]. Diffusion-weighted MR neurography heavily suppresses background body signals to selectively visualize and highlight tissues, such as nerves, with a long T2 relaxation time [13].…”