Semin Musculoskelet Radiol 2018; 22(03): 334-343
DOI: 10.1055/s-0038-1641576
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Getting Started with Magnetic Resonance Neurography

Gustav Andreisek
1   Department of Radiology, Cantonal Hospital Münsterlingen, Münsterlingen, Switzerland
2   University of Zurich, Zurich, Switzerland
,
Nicolae V. Bolog
3   Phoenix Swiss Med, Münchenstein, Switzerland
› Author Affiliations
Further Information

Publication History

Publication Date:
23 May 2018 (online)

Abstract

This article provides a review of magnetic resonance neurography (MRN) and how to get started. It explains step by step how to establish MRN at an institution: how to set up MRN protocols, how to train technicians, what a report needs to contain, and how relevant findings should be communicated to the referring physician. Advanced imaging techniques such as diffusion tensor imaging are only briefly discussed at the end of the article because most of those techniques are difficult for beginners and are still not considered standard in the clinical routine.

 
  • References

  • 1 Chhabra A, Andreisek G, Soldatos T. , et al. MR neurography: past, present, and future. AJR Am J Roentgenol 2011; 197 (03) 583-591
  • 2 Filler AG, Kliot M, Howe FA. , et al. Application of magnetic resonance neurography in the evaluation of patients with peripheral nerve pathology. J Neurosurg 1996; 85 (02) 299-309
  • 3 Chhabra A, Andreisek G. Magnetic Resonance Neurography. London, UK: Jaypee; 2012
  • 4 Chhabra A, Faridian-Aragh N, Chalian M. , et al. High-resolution 3-T MR neurography of peroneal neuropathy. Skeletal Radiol 2012; 41 (03) 257-271
  • 5 Chhabra A. MR neurography. Neuroimaging Clin N Am 2014; 24 (01) xvii
  • 6 Mukherji SK. MR neurography. Neuroimaging Clin N Am 2014; 24 (01) xv
  • 7 Thawait SK, Wang K, Subhawong TK. , et al. Peripheral nerve surgery: the role of high-resolution MR neurography. AJNR Am J Neuroradiol 2012; 33 (02) 203-210
  • 8 Pujol S, Wells W, Pierpaoli C. , et al. The DTI challenge: toward standardized evaluation of diffusion tensor imaging tractography for neurosurgery. J Neuroimaging 2015; 25 (06) 875-882
  • 9 Thawait SK, Chaudhry V, Thawait GK. , et al. High-resolution MR neurography of diffuse peripheral nerve lesions. AJNR Am J Neuroradiol 2011; 32 (08) 1365-1372
  • 10 Reeder SB, Yu H, Johnson JW. , et al. T1- and T2-weighted fast spin-echo imaging of the brachial plexus and cervical spine with IDEAL water-fat separation. J Magn Reson Imaging 2006; 24 (04) 825-832
  • 11 Takemori D, Kimura D, Yamada E, Higashida M. Evaluation of fat suppression of diffusion-weighted imaging using section select gradient reversal technique on 3 T breast MRI. Nippon Hoshasen Gijutsu Gakkai Zasshi 2016; 72 (07) 589-594
  • 12 Chhabra A, Flammang A, Padua Jr A, Carrino JA, Andreisek G. Magnetic resonance neurography: technical considerations. Neuroimaging Clin N Am 2014; 24 (01) 67-78
  • 13 Baumer P, Kele H, Kretschmer T. , et al. Thoracic outlet syndrome in 3T MR neurography-fibrous bands causing discernible lesions of the lower brachial plexus. Eur Radiol 2014; 24 (03) 756-761
  • 14 Chhabra A, Thawait GK, Soldatos T. , et al. High-resolution 3T MR neurography of the brachial plexus and its branches, with emphasis on 3D imaging. AJNR Am J Neuroradiol 2013; 34 (03) 486-497
  • 15 Nordmeyer-Massner JA, Pruessmann KP, Wyss M. , et al. MR imaging of healthy knees in varying degrees of flexion using a stretchable coil array provides comparable image quality compared to a standard knee coil array. Eur J Radiol 2016; 85 (03) 518-523
  • 16 Feng L, Benkert T, Block KT, Sodickson DK, Otazo R, Chandarana H. Compressed sensing for body MRI. J Magn Reson Imaging 2017; 45 (04) 966-987
  • 17 Liu F, Duan Y, Peterson BS, Kangarlu A. Compressed sensing MRI combined with SENSE in partial k-space. Phys Med Biol 2012; 57 (21) N391-N403
  • 18 Chhabra A, Zhao L, Carrino JA. , et al. MR neurography: advances. Radiol Res Pract 2013; 2013: 809568
  • 19 Chhabra A. Peripheral MR neurography: approach to interpretation. Neuroimaging Clin N Am 2014; 24 (01) 79-89
  • 20 Beaulieu C, Does MD, Snyder RE, Allen PS. Changes in water diffusion due to Wallerian degeneration in peripheral nerve. Magn Reson Med 1996; 36 (04) 627-631
  • 21 Behrens L, Bäumer P, Veltkamp R, Meinck HM, Bendszus M, Pham M. MR neurography of acute and regenerated brachial plexus pressure palsy. J Neurol 2013; 260 (12) 3176-3177
  • 22 Thakkar RS, Del Grande F, Thawait GK, Andreisek G, Carrino JA, Chhabra A. Spectrum of high-resolution MRI findings in diabetic neuropathy. AJR Am J Roentgenol 2012; 199 (02) 407-412
  • 23 Chhabra A, Ahlawat S, Belzberg A, Andreseik G. Peripheral nerve injury grading simplified on MR neurography: as referenced to Seddon and Sunderland classifications. Indian J Radiol Imaging 2014; 24 (03) 217-224
  • 24 Husarik DB, Saupe N, Pfirrmann CW, Jost B, Hodler J, Zanetti M. Elbow nerves: MR findings in 60 asymptomatic subjects—normal anatomy, variants, and pitfalls. Radiology 2009; 252 (01) 148-156
  • 25 Yoshizawa H, Kobayashi S, Hachiya Y. Blood supply of nerve roots and dorsal root ganglia. Orthop Clin North Am 1991; 22 (02) 195-211
  • 26 Schwarz D, Weiler M, Pham M, Heiland S, Bendszus M, Bäumer P. Diagnostic signs of motor neuropathy in MR neurography: nerve lesions and muscle denervation. Eur Radiol 2015; 25 (05) 1497-1503
  • 27 Wolf M, Wolf C, Weber MA. Neurogenic myopathies and imaging of muscle denervation [in German]. Radiologe 2017; 57 (12) 1038-1051
  • 28 Gerber C, Meyer DC, Flück M. , et al. Muscle degeneration associated with rotator cuff tendon release and/or denervation in sheep. Am J Sports Med 2017; 45 (03) 651-658
  • 29 Backens M. Basic principles and technique of diffusion-weighted imaging and diffusion tensor imaging [in German]. Radiologe 2015; 55 (09) 762-770
  • 30 Mekle R, Mortamet B, Granziera C. , et al. Magnetization transfer-based 3D visualization of foot peripheral nerves. J Magn Reson Imaging 2013; 37 (05) 1234-1237
  • 31 Bäumer P, Pham M, Ruetters M. , et al. Peripheral neuropathy: detection with diffusion-tensor imaging. Radiology 2014; 273 (01) 185-193
  • 32 Breckwoldt MO, Stock C, Xia A. , et al. Diffusion tensor imaging adds diagnostic accuracy in magnetic resonance neurography. Invest Radiol 2015; 50 (08) 498-504
  • 33 Markvardsen LH, Vaeggemose M, Ringgaard S, Andersen H. Diffusion tensor imaging can be used to detect lesions in peripheral nerves in patients with chronic inflammatory demyelinating polyneuropathy treated with subcutaneous immunoglobulin. Neuroradiology 2016; 58 (08) 745-752
  • 34 Schmidt M, Kasprian G, Amann G, Duscher D, Aszmann OC. Diffusion tensor tractography for the surgical management of peripheral nerve sheath tumors. Neurosurg Focus 2015; 39 (03) E17
  • 35 Zhao L, Wang G, Yang L, Wu L, Lin X, Chhabra A. Diffusion-weighted MR neurography of extremity nerves with unidirectional motion-probing gradients at 3 T: feasibility study. AJR Am J Roentgenol 2013; 200 (05) 1106-1114
  • 36 Menezes CM, de Andrade LM, Herrero CF. , et al. Diffusion-weighted magnetic resonance (DW-MR) neurography of the lumbar plexus in the preoperative planning of lateral access lumbar surgery. Eur Spine J 2015; 24 (04) 817-826
  • 37 Heckel A, Weiler M, Xia A. , et al. Peripheral nerve diffusion tensor imaging: assessment of axon and myelin sheath integrity. PLoS One 2015; 10 (06) e0130833
  • 38 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 (01) 194-203
  • 39 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 (01) 95-101
  • 40 Wu C, Wang G, Zhao Y. , et al. Assessment of tibial and common peroneal nerves in diabetic peripheral neuropathy by diffusion tensor imaging: a case control study. Eur Radiol 2017; 27 (08) 3523-3531
  • 41 Chen YY, Zhang X, Lin XF. , et al. DTI metrics can be used as biomarkers to determine the therapeutic effect of stem cells in acute peripheral nerve injury. J Magn Reson Imaging 2017; 45 (03) 855-862
  • 42 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
  • 43 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 (08) 971-980
  • 44 Simon NG, Lagopoulos J, Gallagher T, Kliot M, Kiernan MC. Peripheral nerve diffusion tensor imaging is reliable and reproducible. J Magn Reson Imaging 2016; 43 (04) 962-969
  • 45 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 (07) e775-e782
  • 46 Kasprian G, Amann G, Panotopoulos J. , et al. Peripheral nerve tractography in soft tissue tumors: a preliminary 3-Tesla diffusion tensor magnetic resonance imaging study. Muscle Nerve 2015; 51 (03) 338-345
  • 47 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 (06) 889-896
  • 48 Yoneyama M, Takahara T, Kwee TC, Nakamura M, Tabuchi T. Rapid high resolution MR neurography with a diffusion-weighted pre-pulse. Magn Reson Med Sci 2013; 12 (02) 111-119
  • 49 Filli L, Piccirelli M, Kenkel D. , et al. Accelerated magnetic resonance diffusion tensor imaging of the median nerve using simultaneous multi-slice echo planar imaging with blipped CAIPIRINHA. Eur Radiol 2016; 26 (06) 1921-1928
  • 50 Jalali-Farahani S, Blakeley JO, Belzberg AJ, Carrino JA, Chhabra A. Plexiform nerve sheath tumor or vascular malformation—role of advanced MR neurography and diffusion tensor imaging. Skeletal Radiol 2013; 42 (07) 1007-1010
  • 51 Manoliu A, Ho M, Nanz D. , et al. MR neurographic orthopantomogram: Ultrashort echo-time imaging of mandibular bone and teeth complemented with high-resolution morphological and functional MR neurography. J Magn Reson Imaging 2016; 44 (02) 393-400