Top-10 Tips for Getting Started with Magnetic Resonance Neurography

Abstract

Magnetic resonance neurography (MRN), also known as MR neurography, is a dedicated imaging technique for the peripheral nerves, used both in a clinical setting and research. However, like any other new diagnostic processes, there are technical, cost, and patient selection issues to overcome as well as potential imaging pitfalls to recognize before MRN can be adopted efficiently into routine clinical practice. This review focuses on the 10 most important practical tips to get started with MRN with a view to shortening the time needed for radiologists to implement this clinically useful technique into their imaging practices.

Neurografía por resonancia magnética: Aspectos técnicos y aplicaciones clínicas

“…El grosor de corte recomendado para extremidades distales de 2-3 mm y en extremidades proximales y plexo de 4-5 mm. La separación entre los cortes debe ser menor o igual a 10% del grosor de corte 23 .…”

Magnetic resonance neurography: is it so complicated that it needs a touch of genius?

“…preoperative determination of the Sunderland injury grade, distinguishing diabetic amyotrophy from radiculopathy, detecting diffuse neuropathy condition like Charcot Marie tooth disease or chronic demyelinating polyneuropathy, characterizing nerve tumour as benign or malignant, finding exact site of nerve entrapment or demonstrating the post-tunnel release re-entrapment, and in addition, determining the regional muscle denervation changes, etc. [6][7][8][9].…”

“…for finding nerve torsion (Fig. 1) [9]. In fact, pudendal, superficial peroneal and smaller sensory nerves like lateral or medial antebrachial cutaneous and radial sensory nerves are best seen on axial 2D imaging, though MRN is ideally suited for fine craniofacial nerves like for facial, lingual, or occipital pain using 3D PSIF or 3D DESS MR imaging.…”

Ultrasound versus MR Neurography in Peripheral Nerve Diseases: Complimentary Rather than Competitive!

“…The accuracy of MRN is highly dependent on the technical parameters and the signal-to-noise ratio (SNR) and resolution may vary highly between 1.5 and 3 T scanners. 2 3 4 The authors rightly acknowledge this as a limitation of their study. In addition, they used a 4-channel flex coil for the extremities, which can be a potential reason for the poorer sensitivity in detecting more superficial nerves.…”

“… 5 6 Because electrodiagnostic tests may not be able to differentiate the different grades of injury, imaging is of paramount importance to guide the management. 3 US can provide the highest resolution to assess the nerve morphology and depending on how superficial/deep the nerve is located; optimal frequency may be selected in the machine. The grading of nerve injury depends primarily on the structural assessment of different parts of the nerve, and thus may be better done on high-resolution US.…”