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Year: 2010 Volume: 112 Issue: 1

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Magnetic resonance neurography for the evaluation of peripheral nerve, brachial plexus, and nerve root disorders.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Du, Rose Auguste, Kurtis I. Chin, Cynthia T. Engstrom, John W. Weinstein, Philip R.
Description	Country affiliation: United States Author Affiliation: Du R ( Department of Neurological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachussetts 02115, USA. rdu@partners.org)
Abstract	OBJECT: Treatment of spinal and peripheral nerve lesions relies on localization of the pathology by the use of neurological examination, spinal MR imaging and electromyography (EMG)/nerve conduction studies (NCSs). Magnetic resonance neurography (MRN) is a novel imaging technique recently developed for direct imaging of spinal and peripheral nerves. In this study, the authors analyzed the role of MRN in the evaluation of spinal and peripheral nerve lesions. METHODS: Imaging studies, medical records, and EMG/NCS results were analyzed retrospectively in a consecutive series of 191 patients who underwent MRN for spinal and peripheral nerve disorders at the University of California, San Francisco between March 1999 and February 2005. Ninety-one (47.6%) of these patients also underwent EMG/NCS studies. RESULTS: In those who underwent both MRN and EMG/NCS, MRN provided the same or additional diagnostic information 32 and 45% of patients, respectively. Magnetic resonance neurograms were obtained at a median of 12 months after the onset of symptoms. The utility of MRN correlated with the interval between the onset of symptoms to MRN. Twelve patients underwent repeated MRN for serial evaluation. The decrease in abnormal signal detected on subsequent MRN correlated with time from onset of symptoms and the time interval between MRN, but not with resolution of symptoms. Twenty-one patients underwent MRN postoperatively to assess persistent, recurrent, or new symptoms; of these 3 (14.3%) required a subsequent surgery. CONCLUSIONS: Magnetic resonance neurography is a valuable adjunct to conventional MR imaging and EMG/NCS in the evaluation and localization of nerve root, brachial plexus, and peripheral nerve lesions. The authors found that MRN is indicated in patients: 1) in whom EMG and traditional MR imaging are inconclusive; 2) who present with brachial plexopathy who have previously received radiation therapy to the brachial plexus region; 3) who present with brachial plexopathy and have systemic tumors; and 4) in patients under consideration for surgery for peripheral nerve lesions or after trauma. Magnetic resonance neurography is limited by the size of the nerve trunk imaged and the timing of the study.
File Format	HTM / HTML
ISSN	00223085
e-ISSN	19330693
Journal	Journal of Neurosurgery
Issue Number	2
Volume Number	112
Language	English
Publisher	American Association of Neurological Surgeons
Publisher Date	2010-02-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Neurosurgery Brachial Plexus Neuropathies Pathology Magnetic Resonance Imaging Peripheral Nervous System Diseases Radiculopathy Adolescent Physiopathology Surgery Child, Preschool Electromyography Muscle, Skeletal Neural Conduction Retrospective Studies Time Factors Evaluation Studies
Content Type	Text
Resource Type	Article
Subject	Neurology (clinical) Surgery

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