Imaging of peripheral nerves using diffusion tensor imaging and MR tractography

Czech version

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: https://doi.org/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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