Three‐tesla magnetic resonance neurography of the brachial plexus in cervical radiculopathy

Yoshida, Takeshi; Sueyoshi, Takeshi; Suwazono, Shugo; Suehara, Masahito

doi:10.1002/mus.24560

Cited by 14 publications

(7 citation statements)

References 15 publications

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“…10 The role of MRN in the work-up of radiculopathy has been recently explored with promising results. 11 There are scattered reports correlating MRN and EMG findings in individuals; however, it remains difficult to draw reliable conclusions about the agreement between MRN and EMG based on limited research studies in the literature with small sample sizes. Retrospective investigations suggest a significant rate of extraspinal pathology in patients with lower extremity radicular symptoms that can be detected with MRN sequences.…”

mentioning

confidence: 99%

MR Neurography of the Lumbosacral Plexus for Lower Extremity Radiculopathy: Frequency of Findings, Characteristics of Abnormal Intraneural Signal, and Correlation with Electromyography

Chazen¹,

Cornman‐Homonoff²,

Zhao

et al. 2018

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: MR neurography enables high resolution imaging of peripheral nerves. Our aim was to evaluate the utility of MR neurography in lumbosacral radiculopathy and correlate abnormal intraneural signal with history, physical examination, and abnormal electrodiagnostic study findings. MATERIALS AND METHODS: Retrospective review of lumbosacral MR neurography examinations performed from December 2014 through January 2017 on a 3T scanner was undertaken. MR neurography examinations were independently reviewed in a blinded fashion by 2 radiologists, and the intraneural signal was graded on a 0-2 scale relative to adjacent vasculature. Abnormal nerve signal was correlated with subjective and objective findings from clinical notes in the electronic medical record and compared with results of electrodiagnostic studies (nerve conduction study/electromyography). RESULTS: Three hundred three lumbosacral MR neurography examinations were performed during the study period, 64 of which met the inclusion criteria, including symptoms of radiculopathy on electromyography performed within 3 months of MR neurography. Twentynine (45%) MR neurography examinations had abnormal intraneural signal. There was no statistically significant correlation between subjective clinical findings and intraneural signal abnormality on MR neurography. There was a statistically significant correlation between abnormal intraneural T2 signal and findings of active radiculopathy on electromyography (P Ͻ .001). CONCLUSIONS: Lumbosacral MR neurography appears to demonstrate abnormal intraneural signal in a substantial portion of patients with clinical symptoms of lower extremity radiculopathy and correlates with findings of active radiculopathy on electromyography. This finding further bolsters the growing body of evidence on the utility of MR neurography and suggests that abnormal intraneural signal may provide a useful adjunct to electrodiagnostic testing. Further research is required to evaluate the prognostic value of MR neurography, which may help guide therapeutic decision-making. ABBREVIATIONS: EMG ϭ electromyography; MRN ϭ MR neurography; MUAP ϭ motor unit action potential; NCS ϭ nerve conduction study; SPAIR ϭ spectral adiabatic inversion recovery L umbosacral radiculopathy has a prevalence of approximately 3%-5% in the general population. 1 It affects men and women equally, though the onset in men is, on average, a decade earlier than in women. 1 Clinical evaluation relies predominantly on history and physical examination. Electrodiagnostic testing including needle electromyography (EMG) has been described as an "extension" of the clinical examination but remains an imperfect

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mentioning

confidence: 99%

MR Neurography of the Lumbosacral Plexus for Lower Extremity Radiculopathy: Frequency of Findings, Characteristics of Abnormal Intraneural Signal, and Correlation with Electromyography

Chazen¹,

Cornman‐Homonoff²,

Zhao

et al. 2018

AJNR Am J Neuroradiol

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“…The coronal STIR sequence we used in this study requires only 5 min and is easily translated into standard protocols. In this sequence, nerve roots and the brachial plexus can also be examined, adding diagnostic utility 2 . Conversely, this assessment may not be more accurate than EMG data in detecting denervation‐related changes.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of cervical radiculopathy (CR) can be difficult because brachial plexopathy and other peripheral nerve disorders can present with similar pain and neurological symptoms 1‐3 . Examination of the multifidus muscle via needle electromyography (EMG) is shown to be sensitive and specific for the clinical diagnosis of lumbar spinal stenosis 4,5 and to also accurately differentiate radiculopathy from plexopathy 6 .…”

Section: Introductionmentioning

confidence: 99%

Diagnostic usefulness of denervation edema in the multifidus muscles using 3‐Tesla magnetic resonance imaging in cervical radiculopathy

Yoshida

Suwazono

Sueyoshi³

et al. 2020

Muscle and Nerve

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Background Diagnosing cervical radiculopathy (CR) can be difficult because of symptomatic overlap with peripheral neuropathies. In this retrospective observational study, we aimed to determine whether short‐tau inversion recovery (STIR) magnetic resonance imaging (MRI) sequences are useful for detecting signs of denervation in the multifidus muscles in patients with CR. Methods We analyzed the data of 18 patients with CR who developed arm weakness within 1 year. We also included 10 patients with sensorimotor symptoms involving the upper extremities who did not have intervertebral foraminal stenosis on MRI as controls. For each patient with CR, the signal intensity (SI) of the affected multifidus muscles was measured and compared to that on the contralateral side (signal intensity ratio: SIR). Results Control patients without CR did not exhibit STIR signal abnormalities in the multifidus muscles. Most of the 18 patients with CR were male (83.3%), and the mean age was 59.4 years. Thirteen of 18 CR patients (72.2%) were determined to have STIR signal abnormalities by a radiologist. The mean SIR in the 13 patients with increased SI was significantly higher than that in the five patients without signal abnormalities (1.23 vs 0.97, P = .004), supporting the radiologist's diagnosis. The distribution of signal abnormalities closely followed those identified via clinical and electrophysiological tests, especially severe weakness (P = .044). Conclusions Denervation edema of the multifidus muscles can be detected in CR and correlates with clinical/electrophysiological tests and weakness severity, which may aid in CR diagnostics.

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“… 7 Furthermore, conditions such as cervical spondylosis-related radiculopathy or cervical disc herniation present similar to brachial plexopathies. 7 8 9 Thus, a precise technique is required for evaluation. MRN has become a valuable diagnostic tool for brachial plexopathies caused by trauma, acute or chronic inflammation, brachial plexus tumors, and thoracic outlet syndrome 10 11 as it can locate the site of neurologic compromise with a high degree of precision.…”

Section: Brachial Plexusmentioning

confidence: 99%

Magnetic Resonance Neurography for Evaluation of Peripheral Nerves

Cox

Mikeska

2021

J Brachial Plex Peripher Nerve Inj

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Peripheral nerve injuries (PNIs) continue to present both diagnostic and treatment challenges. While nerve transections are typically a straightforward diagnosis, other types of PNIs, such as chronic or traumatic nerve compression, may be more difficult to evaluate due to their varied presentation and limitations of current diagnostic tools. As a result, diagnosis may be delayed, and these patients may go on to develop progressive symptoms, impeding normal activity. In the past, PNIs were diagnosed by history and clinical examination alone or techniques that raised concerns regarding accuracy, invasiveness, or operator dependency. Magnetic resonance neurography (MRN) has been increasingly utilized in clinical settings due to its ability to visualize complex nerve structures along their entire pathway and distinguish nerves from surrounding vasculature and tissue in a noninvasive manner. In this review, we discuss the clinical applications of MRN in the diagnosis, as well as pre- and postsurgical assessments of patients with peripheral neuropathies.

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Three‐tesla magnetic resonance neurography of the brachial plexus in cervical radiculopathy

Cited by 14 publications

References 15 publications

MR Neurography of the Lumbosacral Plexus for Lower Extremity Radiculopathy: Frequency of Findings, Characteristics of Abnormal Intraneural Signal, and Correlation with Electromyography

MR Neurography of the Lumbosacral Plexus for Lower Extremity Radiculopathy: Frequency of Findings, Characteristics of Abnormal Intraneural Signal, and Correlation with Electromyography

Diagnostic usefulness of denervation edema in the multifidus muscles using 3‐Tesla magnetic resonance imaging in cervical radiculopathy

Magnetic Resonance Neurography for Evaluation of Peripheral Nerves

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