Imag­­ing of peripheral nerves us­­ing dif­fusion tensor imag­­ing and MR tractography


Authors: I. Humhej 1;  I. Ibrahim 2;  M. Sameš 1;  J. Tintěra 2;  D. Hořínek 3;  I. Čižmář 4
Authors‘ workplace: Neurochirurgická klinika FZS UJEP, Krajská zdravotní a. s., Masarykova nemocnice v Ústí nad Labem o. z. 1;  Základna radiodiagnostiky a intervenční radiologie, IKEM, Praha 2;  Neurochirurgická klinika dětí a dospělých 2. LF UK a FN Motol, Praha 3;  Traumatologická klinika LF UP a FN Olomouc 4
Published in: Cesk Slov Neurol N 2018; 81(4): 420-426
Category: Original Paper
doi: 10.14735/amcsnn2018csnn.eu3

Overview

Aim:
Development of an examination protocol for investigation of functional integrity and microstructural damage of peripheral nerves (PN) at dif­ferent locations us­­ing dif­fusion tensor imag­­ing (DTI). Consequently, we want to implement this protocol into clinical practice.

Subjects and methods: We investigated 15 healthy volunteers and 15 patients with a 3T MRI, scan­ner us­­ing the DTI method. We attempted to visualize the brachial plexus, lumbosacral plexus and the course of PN in the limbs of healthy volunteers. In patients, we focused on the examination of damaged parts of the PN to display these pathologies.

Results: We managed to obtain a valid visualization of the brachial plexus, lumbosacral plexus and the course of PN in the limbs us­­ing DTI. Throughout the study, we encountered some limitations of this method, particularly motion artifacts which interfered with the quality of nerve structure imag­­ing and problems in dif­ferentiat­­ing nerve fibers from muscle fibers. These technical problems could be reduced to a certain extent us­­ing adequate coils, optimiz­­ing imag­­ing protocols and data proces­s­­ing methodology.

Conclusion: Despite some technical limitations, this paper demonstrates the pos­sibility of obtain­­ing a valid display of PN in dif­ferent locations us­­ing the DTI method. DTI is an additional non-invasive imag­­ing technique provid­­ing valuable information useful in the decision-mak­­ing dia­gnostic and therapeutic process for various PN pathologies. Technological advances and further improvements of MRI techniques in the future are likely to result in a wider use of this technique in clinical practice.

Key words:
magnetic resonance imaging – diffusion tensor imaging – MR tractography – peripheral nerves – brachial plexus – lumbo­sacral plexus

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­ script met the ICMJE “uniform requirements” for biomedical papers.


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Paediatric neurology Neurosurgery Neurology

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