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 place of work:
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 the journal:
Cesk Slov Neurol N 2018; 81(4): 420-426
Category:
Původní práce
doi:
https://doi.org/10.14735/amcsnn2018csnn.eu3
Summary
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.
Zdroje
1. Jeon T, Fung MM, Koch KM et al. Peripheral nerve diffusion tensor imaging: overview, pitfalls, and future directions. J Magn Reson Imaging 2017; 47(5): 1171– 1189. doi: 10.1002/ jmri.25876.
2. Basser PJ, Mattiello J, LeBihan D. MR diffusion tensor spectroscopy and imaging. Biophys J 1994; 66(1): 259– 267. doi: 10.1016/ S0006-3495(94)80775-1.
3. Keřkovský M, Šprláková-Puková A, Kašpárek T et al.Diffusion tensor imaging – současné možnosti MRzobrazení bílé hmoty mozku. Cesk Slov Neurol N 2010; 73/ 106(2): 136– 142.
4. Ibrahim I, Tintěra J. Teoretické základy pokročilých metod magnetické rezonance na poli neurověd. Ces Radiol 2013; 67(1): 9– 19.
5. Mori S, Crain BJ, Chacko VP et al. Three- dimensional tracking of axonal projections in the brain by magnetic resonance imaging. Ann Neurol 1999; 45(2): 265– 269.
6. Berman J. Diffusion MR tractography as a tool for surgical planning. Magn Reson Imaging Clin N Am 2009; 17(2): 205– 214. doi: 10.1016/ j.mric.2009.02.002.
7. Zolal A, Sameš M, Vachata P et al. Použití DTI traktografie v neuronavigaci při operacích mozkových nádorů: kazuistiky. Cesk Slov Neurol N 2008; 71/ 104(3): 352– 357.
8. 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. doi: 10.1016/ j.neuroimage.2008.09.022.
9. Lehmann HC, Zhang J, Mori S et al. Diffusion tensor imaging to assess axonal regeneration in peripheral nerves. Exp Neurol 2010; 223(1): 238– 244. doi: 10.1016/ j.expneurol.2009.10.012.
10. 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. doi: 10.1002/ jmri.22442.
11. Boyer RB, Kelm ND, Riley DC et al. 4.7-T diffusion tensor imaging of acute traumatic peripheral nerve injury. Neurosurg Focus 2015; 39(3): E9. doi: 10.3171/ 2015.6.FOCUS1590.
12. Jambawalikar S, Baum J, Button T et al. Diffusion tensor imaging of peripheral nerves. Skeletal Radiol 2010; 39(11): 1073– 1079. doi: 10.1007/ s00256-010-0974-5.
13. Hiltunen J, Suortti T, Arvela S et al. Diffusion tensor imaging and tractography of distal peripheral nerves at 3 T. Clin Neurophysiol 2005; 116(10): 2315– 2323. doi: 10.1016/ j.clinph.2005.05.014.
14. Zhou Y, Kumaravel M, Patel VS et al. Diffusion tensor imaging of forearm nerves in humans. J Magn Reson Imaging 2012; 36(4): 920– 927. doi: 10.1002/ jmri.23709.
15. Skorpil M, Engström M, Nordell A. Diffusion-direction-dependent imaging: a novel MRI approach for peripheral nerve imaging. Magn Reson Imaging 2007; 25(3): 406– 411. doi: 10.1016/ j.mri.2006.09.017.
16. Simon NG, Lagopoulos J, Gallagher T et al. Peripheral nerve diffusion tensor imaging is reliable and reproducible. J Magn Reson Imaging 2016; 43(4): 962– 969. doi: 10.1002/ jmri.25056.
17. Chenevert TL, Brunberg JA, Pipe JG. Anistropic diffusion in human white matter: demonstration with MR techniques in vivo. Radiology 1990; 177(2): 401– 405.
18. Bammer R, Fazekas F, Augustin M et al. Diffusion-weighted MR imaging of the spinal cord. AJNR Am J Neuroradiol 2000; 21(3): 587– 591.
19. Song T, Chen WJ, Yang B et al. Diffusion tensor imaging in the cervical spinal cord. Eur Spine J 2011; 20(3): 422– 428. doi: 10.1007/ s00586-010-1587-3.
20. Skorpil M, Karlsson M, Nordell A. Peripheral nerve diffusion tensor imaging. Magn Reson Imaging 2004; 22(5): 743– 745. doi: 10.1016/ j.mri.2004.01.073.
21. Kwon BC, Koh SH, Hwang SY. Optimal parameters and location for diffusion-tensor imaging in the diagnosis of carpal tunnel syndrome: a prospective matched case-control study. AJR Am J Roentgenol 2015; 204(6): 1248– 1254. doi: 10.2214/ AJR.14.13371.
22. 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. doi: 10.1148/ radiol.12111403.
23. 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 Radiol2013; 42(10): 1403– 1412. doi: 10.1007/ s00256-013-1670-z.
24. Hiltunen J, Kirveskari E, Numminen J et al. Pre- and post-operative diffusion tensor imaging of the median nerve in carpal tunnel syndrome. Eur Radiol 2012; 22(6): 1310– 1319. doi: 10.1007/ s00330-012-2381-x.
25. Breitenseher JB, Kranz G, Hold A et al. MR neurography of ulnar nerve entrapment at the cubital tunnel: a diffusion tensor imaging study. Eur Radiol 2015; 25(7): 1911– 1918. doi: 10.1007/ s00330-015-3613-7.
26. Iba K, Wada T, Tamakawa M et al. Diffusion-weighted magnetic resonance imaging of the ulnar nerve in cubital tunnel syndrome. Hand Surg 2010; 15(1): 11– 15. doi: 10.1142/ S021881041000445X.
27. Magill ST, Brus-Ramer M, Weinstein PR et al. Neurogenic thoracic outlet syndrome: current diagnostic criteria and advances in MRI diagnostics. Neurosurg Focus 2015; 39(3): E7. doi: 10.3171/ 2015.6.FOCUS15219.
28. Gallagher TA, Simon NG, Kliot M. Diffusion tensor imaging to visualize axons in the setting of nerve injury and recovery. Neurosurg Focus 2015; 39(3): E10. doi: 10.3171/ 2015.6.FOCUS15211.
29. Gasparotti R, Lodoli G, Meoded A et al. Feasibility of diffusion tensor tractography of brachial plexus injuries at 1.5 T. Invest Radiol 2013; 48(2): 104– 112. doi: 10.1097/ RLI.0b013e3182775267.
30. Ho MJ, Manoliu A, Kuhn FP et al. Evaluation of reproducibility of diffusion tensor imaging in the brachial plexus at 3.0 T. Invest Radiol 2017; 52(8): 482– 487. doi: 10.1097/ RLI.0000000000000363.
31. Tagliafico A, Calabrese M, Puntoni M et al. Brachial plexus MR imaging: accuracy and reproducibility of DTI-derived measurements and fibre tractography at 3.0-T. Eur Radiol 2011; 21(8): 1764– 1771. doi: 10.1007/ s00330-011-2100-z.
32. Budzik JF, Verclytte S, Lefebvre G et al. 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. doi: 10.1007/ s00330-012-2710-0.
33. van der Jagt PK, Dik P, Froeling M et al. Architectural configuration and microstructural properties of the sacral plexus: a diffusion tensor MRI and fiber tractography study. Neuroimage 2012; 62(3): 1792– 1799. doi: 10.1016/ j.neuroimage.2012.06.001.
34. Shi Y, Zong M, Xu X et al. Diffusion tensor imaging with quantitative evaluation and fiber tractography of lumbar nerve roots in sciatica. Eur J Radiol 2015; 84(4): 690– 695. doi: 10.1016/ j.ejrad.2015.01.006.
35. Kanamoto H, Eguchi Y, Oikawa Y et al. Visualization of lumbar nerves using reduced field of view diffusion tensor imaging in healthy volunteers and patients with degenerative lumbar disorders. Br J Radiol 2017; 90(1080): 20160929. doi: 10.1259/ bjr.20160929.
36. Schmidt M, Kasprian G, Amann G et al. Diffusion tensor tractography for the surgical management of peripheral nerve sheath tumors. Neurosurg Focus 2015; 39(3): E17. doi: 10.3171/ 2015.6.FOCUS15228.
37. Cage TA, Yuh EL, Hou SW et al. Visualization of nerve fibers and their relationship to peripheral nerve tumors by diffusion tensor imaging. Neurosurg Focus 2015; 39(3): E16. doi: 10.3171/ 2015.6.FOCUS15235.
38. 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. doi: 10.3174/ ajnr.A3316.
39. Heckel A, Weiler M, Xia A et al. peripheral nerve diffusion tensor imaging: assessment of axon and myelin sheath integrity. PLoS One 2015; 10(6): e0130833. doi: 10.1371/ journal.pone.0130833.
40. Kronlage M, Pitarokoili K, Schwarz D et al. Diffusion tensor imaging in chronic inflammatory demyelinating polyneuropathy: diagnostic accuracy and correlation with electrophysiology. Invest Radiol 2017; 52(11): 701– 707. doi: 10.1097/ RLI.0000000000000394.
Štítky
Detská neurológia Neurochirurgia NeurológiaČlánok vyšiel v časopise
Česká a slovenská neurologie a neurochirurgie
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