Magnetic resonance neurography of peripheral nerve lesions in the lower extremity

Charles Kuntz IV, Lindsey Blake, Gavin Britz, Aaron Filler, Cecil E. Hayes, Robert Goodkin, Jay Tsuruda, Ken Maravilla, Michel Kliot*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

98 Scopus citations

Abstract

OBJECTIVE: We describe the clinical application and utility of high- resolution magnetic resonance neurography (MRN) techniques to image the normal fascicular structure of peripheral nerves and its distortion by mass lesions or trauma in the lower extremity. METHODS: MRN images were obtained using a standard 1.5 Tesla magnet and custom built phased-array coils. Patients were imaged using T1-weighted spin echo without and with gadolinium, T2-weighted fast spin echo with fat suppression, and short tau inversion recovery fast spin-echo pulse sequences. Nine patients were studied, four with peripheral nerve tumors (three neurofibromas and one schwannoma), two with intraneural cysts, and three with traumatic peripheral nerve lesions. Six patients with peripheral nerve mass lesions underwent surgery, thereby allowing MRN images to be correlated with intraoperative and pathological findings. RESULTS: Preoperative MRN accurately imaged the normal fascicular anatomy of peripheral nerves and precisely depicted its relation to tumor and cystic lesions. Increased signal on T2-weighted fast spin-echo and short tau inversion recovery fast spin-echo pulse sequences was seen in the peripheral nerve fascicles of patients with clinical and electrodiagnostic evidence of nerve injury. CONCLUSION: MRN proved useful in the preoperative evaluation and planning of surgery in patients with peripheral nerve lesions.

Original languageEnglish (US)
Pages (from-to)750-757
Number of pages8
JournalNeurosurgery
Volume39
Issue number4
DOIs
StatePublished - Oct 1996

Keywords

  • Cyst
  • Magnetic resonance imaging
  • Neurofibroma
  • Neuropathy
  • Peripheral nerve
  • Schwannoma
  • Trauma
  • Tumor

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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