Magnetic resonance neurography of peripheral nerve lesions in the lower extremity.
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 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.


CONCLUSIONS
MRN proved useful in the preoperative evaluation and planning of surgery in patients with peripheral nerve lesions.
Kuntz
C
C
Department of Neurological Surgery, University of Washington, Seattle, USA.
Blake
L
L
Britz
G
G
Filler
A
A
Hayes
C E
CE
Goodkin
R
R
Tsuruda
J
J
Maravilla
K
K
Kliot
M
M
D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D006801:Humans; D007866:Leg / Q000294:innervation*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D059348:Peripheral Nerve Injuries; D010525:Peripheral Nerves / Q000473:pathology / Q000601:surgery; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010524:Peripheral Nervous System Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012680:Sensitivity and Specificity; D016896:Treatment Outcome