Demonstration of spinal cord and nerve root abnormalities by diffusion neurography.
OBJECTIVE
Diffusion-weighted magnetic resonance imaging postprocessed by maximum-intensity projection reportedly demonstrates the nerve roots. We modified this technique using a fluid-attenuated inversion-recovery-based diffusion-tensor scan using parallel imaging and evaluated its feasibility in demonstrating spinal cord and nerve root abnormalities.


METHODS
We applied this technique to 18 patients with miscellaneous pathological conditions that included multiple sclerosis, chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), neurofibromatosis (NF), schwannoma, cord injury, and tethered cord. The neurographic images were visually assessed regarding the lesion depiction.


RESULTS
In each subject, not only the cord but also the nerve roots were visualized. This technique demonstrated cord plaques of multiple sclerosis (5/6 cases), enlarged nerve roots in CIDP (3/3 cases), multiple neurogenic tumors in NF (3/3 cases), and schwannoma (1/1 case). It better demonstrated nerve root abnormalities of CIDP (3/3 cases) and NF (2/3 cases) than conventional magnetic resonance images.


CONCLUSIONS
This technique can effectively demonstrate most of the cord and nerve root pathology.
Tsuchiya
Kazuhiro
K
Department of Radiology, Kyorin University School of Medicine, Tokyo, Japan. tsuchiyak-kyr@umin.ac.jp
Honya
Keita
K
Yoshida
Maiko
M
Nitatori
Toshiaki
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003943:Diagnostic Techniques, Neurological; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis*; D015588:Observer Variation; D013116:Spinal Cord / Q000002:abnormalities* / Q000473:pathology*; D013126:Spinal Nerve Roots / Q000002:abnormalities* / Q000473:pathology*