Diffusion Tensor Imaging of Peripheral Nerves

Abstract

Diffusion tensor imaging (DTI) is a powerful MR imaging technique that can be used to probe the microstructural environment of highly anisotropic tissues such as peripheral nerves. DTI has been used predominantly in the central nervous system, and its application in the peripheral nervous system does pose some challenges related to imaging artifacts, the small caliber of peripheral nerves, and low water proton density. However advances in MRI hardware and software have made it possible to use the technique in the peripheral nervous system and to obtain functional data relating to the effect of pathologic processes on peripheral nerves. This article reviews the imaging principles behind DTI and examines the literature regarding its application in assessing peripheral nerves.

Keywords

diffusion tensor imaging - MRI - peripheral nerves - MRN

• References

• 1 Lerner A, Mogensen MA, Kim PE, Shiroishi MS, Hwang DH, Law M. Clinical applications of diffusion tensor imaging. World Neurosurg 2014; 82 (1–2) 96-109
• 2 Mukherjee P, Berman JI, Chung SW, Hess CP, Henry RG. Diffusion tensor MR imaging and fiber tractography: theoretic underpinnings. AJNR Am J Neuroradiol 2008; 29 (4) 632-641
• 3 DeLano MC, Cao Y. High b-value diffusion imaging. Neuroimaging Clin N Am 2002; 12 (1) 21-34
• 4 Mukherjee P, Chung SW, Berman JI, Hess CP, Henry RG. Diffusion tensor MR imaging and fiber tractography: technical considerations. AJNR Am J Neuroradiol 2008; 29 (5) 843-852
• 5 Le Bihan D, Poupon C, Amadon A, Lethimonnier F. Artifacts and pitfalls in diffusion MRI. J Magn Reson Imaging 2006; 24 (3) 478-488
• 6 Kabakci N, Gürses B, Firat Z , et al. Diffusion tensor imaging and tractography of median nerve: normative diffusion values. AJR Am J Roentgenol 2007; 189 (4) 923-927
• 7 Khalil C, Hancart C, Le Thuc V, Chantelot C, Chechin D, Cotten A. Diffusion tensor imaging and tractography of the median nerve in carpal tunnel syndrome: preliminary results. Eur Radiol 2008; 18 (10) 2283-2291
• 8 Stein D, Neufeld A, Pasternak O , et al. Diffusion tensor imaging of the median nerve in healthy and carpal tunnel syndrome subjects. J Magn Reson Imaging 2009; 29 (3) 657-662
• 9 Yao L, Gai N. Median nerve cross-sectional area and MRI diffusion characteristics: normative values at the carpal tunnel. Skeletal Radiol 2009; 38 (4) 355-361
• 10 Andreisek G, White LM, Kassner A, Tomlinson G, Sussman MS. Diffusion tensor imaging and fiber tractography of the median nerve at 1.5T: optimization of b value. Skeletal Radiol 2009; 38 (1) 51-59
• 11 Guggenberger R, Eppenberger P, Markovic D , et al. MR neurography of the median nerve at 3.0T: optimization of diffusion tensor imaging and fiber tractography. Eur J Radiol 2012; 81 (7) e775-e782
• 12 Jones DK. The effect of gradient sampling schemes on measures derived from diffusion tensor MRI: a Monte Carlo study. Magn Reson Med 2004; 51 (4) 807-815
• 13 Chhabra A, Thakkar RS, Andreisek G , et al. Anatomic MR imaging and functional diffusion tensor imaging of peripheral nerve tumors and tumorlike conditions. AJNR Am J Neuroradiol 2013; 34 (4) 802-807
• 14 Guggenberger R, Nanz D, Puippe G , et al. Diffusion tensor imaging of the median nerve: intra-, inter-reader agreement, and agreement between two software packages. Skeletal Radiol 2012; 41 (8) 971-980
• 15 Guggenberger R, Nanz D, Bussmann L , et al. Diffusion tensor imaging of the median nerve at 3.0 T using different MR scanners: agreement of FA and ADC measurements. Eur J Radiol 2013; 82 (10) e590-e596
• 16 Barcelo C, Faruch M, Lapègue F, Bayol MA, Sans N. 3-T MRI with diffusion tensor imaging and tractography of the median nerve. Eur Radiol 2013; 23 (11) 3124-3130
• 17 Koh SH, Kwon BC, Park C, Hwang SY, Lee JW, Kim SS. A comparison of the performance of anatomical MRI and DTI in diagnosing carpal tunnel syndrome. Eur J Radiol 2014; 83 (11) 2065-2073
• 18 Kakuda T, Fukuda H, Tanitame K , et al. Diffusion tensor imaging of peripheral nerve in patients with chronic inflammatory demyelinating polyradiculoneuropathy: a feasibility study. Neuroradiology 2011; 53 (12) 955-960
• 19 Takagi T, Nakamura M, Yamada M , et al. Visualization of peripheral nerve degeneration and regeneration: monitoring with diffusion tensor tractography. Neuroimage 2009; 44 (3) 884-892
• 20 Lehmann HC, Zhang J, Mori S, Sheikh KA. Diffusion tensor imaging to assess axonal regeneration in peripheral nerves. Exp Neurol 2010; 223 (1) 238-244
• 21 Morisaki S, Kawai Y, Umeda M , et al. In vivo assessment of peripheral nerve regeneration by diffusion tensor imaging. J Magn Reson Imaging 2011; 33 (3) 535-542
• 22 Sun SW, Liang HF, Le TQ, Armstrong RC, Cross AH, Song SK. Differential sensitivity of in vivo and ex vivo diffusion tensor imaging to evolving optic nerve injury in mice with retinal ischemia. Neuroimage 2006; 32 (3) 1195-1204
• 23 Song SK, Sun SW, Ramsbottom MJ, Chang C, Russell J, Cross AH. Dysmyelination revealed through MRI as increased radial (but unchanged axial) diffusion of water. Neuroimage 2002; 17 (3) 1429-1436
• 24 Santarelli X, Garbin G, Ukmar M, Longo R. Dependence of the fractional anisotropy in cervical spine from the number of diffusion gradients, repeated acquisition and voxel size. Magn Reson Imaging 2010; 28 (1) 70-76
• 25 Farrell JA, Landman BA, Jones CK , et al. Effects of signal-to-noise ratio on the accuracy and reproducibility of diffusion tensor imaging-derived fractional anisotropy, mean diffusivity, and principal eigenvector measurements at 1.5 T. J Magn Reson Imaging 2007; 26 (3) 756-767
• 26 Skorpil M, Karlsson M, Nordell A. Peripheral nerve diffusion tensor imaging. Magn Reson Imaging 2004; 22 (5) 743-745
• 27 Hiltunen J, Suortti T, Arvela S, Seppä M, Joensuu R, Hari R. Diffusion tensor imaging and tractography of distal peripheral nerves at 3 T. Clin Neurophysiol 2005; 116 (10) 2315-2323
• 28 Guggenberger R, Markovic D, Eppenberger P , et al. Assessment of median nerve with MR neurography by using diffusion-tensor imaging: normative and pathologic diffusion values. Radiology 2012; 265 (1) 194-203
• 29 Andreisek G, White LM, Kassner A, Sussman MS. Evaluation of diffusion tensor imaging and fiber tractography of the median nerve: preliminary results on intrasubject variability and precision of measurements. AJR Am J Roentgenol 2010; 194 (1) W65–W72
• 30 Bulut HT, Yildirim A, Ekmekci B, Gunbey HP. The diagnostic and grading value of diffusion tensor imaging in patients with carpal tunnel syndrome. Acad Radiol 2014; 21 (6) 767-773
• 31 Klauser AS, Halpern EJ, De Zordo T , et al. Carpal tunnel syndrome assessment with US: value of additional cross-sectional area measurements of the median nerve in patients versus healthy volunteers. Radiology 2009; 250 (1) 171-177
• 32 Hiltunen J, Kirveskari E, Numminen J, Lindfors N, Göransson H, Hari R. Pre- and post-operative diffusion tensor imaging of the median nerve in carpal tunnel syndrome. Eur Radiol 2012; 22 (6) 1310-1319
• 33 Naraghi A, da Gama Lobo L, Menezes R , et al. Diffusion tensor imaging of the median nerve before and after carpal tunnel release in patients with carpal tunnel syndrome: feasibility study. Skeletal Radiol 2013; 42 (10) 1403-1412
• 34 Bäumer P, Pham M, Ruetters M , et al. Peripheral neuropathy: detection with diffusion-tensor imaging. Radiology 2014; 273 (1) 185-193
• 35 Zhou Y, Kumaravel M, Patel VS, Sheikh KA, Narayana PA. Diffusion tensor imaging of forearm nerves in humans. J Magn Reson Imaging 2012; 36 (4) 920-927
• 36 Zhou Y, Narayana PA, Kumaravel M, Athar P, Patel VS, Sheikh KA. High resolution diffusion tensor imaging of human nerves in forearm. J Magn Reson Imaging 2014; 39 (6) 1374-1383
• 37 Yamasaki T, Fujiwara H, Oda R , et al. In vivo evaluation of rabbit sciatic nerve regeneration with diffusion tensor imaging (DTI): correlations with histology and behavior. Magn Reson Imaging 2015; 33 (1) 95-101
• 38 Li X, Chen J, Hong G , et al. In vivo DTI longitudinal measurements of acute sciatic nerve traction injury and the association with pathological and functional changes. Eur J Radiol 2013; 82 (11) e707-e714
• 39 Meek MF, Stenekes MW, Hoogduin HM, Nicolai JP. In vivo three-dimensional reconstruction of human median nerves by diffusion tensor imaging. Exp Neurol 2006; 198 (2) 479-482
• 40 Chen YY, Lin XF, Zhang F , et al. Diffusion tensor imaging of symptomatic nerve roots in patients with cervical disc herniation. Acad Radiol 2014; 21 (3) 338-344
• 41 Balbi V, Budzik JF, Duhamel A, Bera-Louville A, Le Thuc V, Cotten A. Tractography of lumbar nerve roots: initial results. Eur Radiol 2011; 21 (6) 1153-1159
• 42 Eguchi Y, Ohtori S, Orita S , et al. Quantitative evaluation and visualization of lumbar foraminal nerve root entrapment by using diffusion tensor imaging: preliminary results. AJNR Am J Neuroradiol 2011; 32 (10) 1824-1829
• 43 Chuanting L, Qingzheng W, Wenfeng X, Yiyi H, Bin Z. 3.0T MRI tractography of lumbar nerve roots in disc herniation. Acta Radiol 2014; 55 (8) 969-975
• 44 Budzik JF, Verclytte S, Lefebvre G, Monnet A, Forzy G, Cotten A. Assessment of reduced field of view in diffusion tensor imaging of the lumbar nerve roots at 3 T. Eur Radiol 2013; 23 (5) 1361-1366
• 45 Finsterbusch J. High-resolution diffusion tensor imaging with inner field-of-view EPI. J Magn Reson Imaging 2009; 29 (4) 987-993
• 46 Gaggl W, Jesmanowicz A, Prost RW. High-resolution reduced field of view diffusion tensor imaging using spatially selective RF pulses. Magn Reson Med 2014; 72 (6) 1668-1679
• 47 Wilm BJ, Svensson J, Henning A, Pruessmann KP, Boesiger P, Kollias SS. Reduced field-of-view MRI using outer volume suppression for spinal cord diffusion imaging. Magn Reson Med 2007; 57 (3) 625-630
• 48 Vargas MI, Viallon M, Nguyen D, Delavelle J, Becker M. Diffusion tensor imaging (DTI) and tractography of the brachial plexus: feasibility and initial experience in neoplastic conditions. Neuroradiology 2010; 52 (3) 237-245
• 49 Kasprian G, Amann G, Panotopoulos J , et al. Peripheral nerve tractography in soft tissue tumors: a preliminary 3 tesla DTI study. Muscle Nerve 2014; ; June 11 (Epub ahead of print)
• 50 Mathys C, Aissa J, Meyer Zu Hörste G , et al. Peripheral neuropathy: assessment of proximal nerve integrity by diffusion tensor imaging. Muscle Nerve 2013; 48 (6) 889-896