title: Diffusion-weighted MR neurography of median and ulnar nerves in the wrist and palm.
abstract: OBJECTIVE
  To investigate the feasibility of diffusion-weighted magnetic resonance neurography (DW-MRN) in the visualisation of extremity nerves in the wrist and palm.
  
  
  METHODS
  Thirty-two volunteers and 21 patients underwent imaging of the wrist and palm on a 3-T MR scanner. In all subjects, two radiologists evaluated the image quality on DW-MRN using a four-point grading scale. Kappa statistics were obtained for inter-observer performance. In volunteers, the chi-squared test was used to assess the differences in nerve visualisation on DW-MRN and axial fat-suppressed proton density weighted imaging (FS-PDWI).
  
  
  RESULTS
  In volunteers, the mean image quality scores for the median nerve (MN) and ulnar nerve (UN) were 3.71 ± 0.46 and 3.23 ± 0.67 for observer 1, and 3.70 ± 0.46 and 3.22 ± 0.71 for observer 2, respectively. The inter-observer agreement was excellent (k = 0.843) and good (k = 0.788), respectively. DW-MRN provided significantly improved visualisations of the second and the third common palmar digital nerves and three branches of UN compared with FS-PDWI (P < 0.05). In patients, the mean image quality scores for the two observers were 3.24 ± 0.62 and 3.10 ± 0.83, inter-observer performance was excellent (k = 0.842).
  
  
  CONCLUSIONS
  DW-MRN is feasible for improved visualisation of extremity nerves and their lesions in the wrist and palm with adequate image quality, thereby providing a supplementary method to conventional MR imaging.
  
  
  CONCLUSIONS
  • DW-MRN provides adequate image quality for wrist and palm neurography • DW-MRN performs similarly to FS-PDWI in nerve visualisation at the wrist • DW-MRN provides improved visualisation of small nerves in the palm • DW-MRN serves as a supplementary method to evaluate peripheral neuropathies.
authors.affiliation: Department of MR, Shandong Medical Imaging Research Institute Affiliated to Shandong University, Shandong University, 324 Jingwu Rd, Jinan, 250021, Shandong, People's Republic of China.
authors.forename: Hongjing
authors.initials: H
authors.lastname: Bao
authors.affiliation: Department of MR, Shandong Medical Imaging Research Institute Affiliated to Shandong University, Shandong University, 324 Jingwu Rd, Jinan, 250021, Shandong, People's Republic of China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of MR, Shandong Medical Imaging Research Institute Affiliated to Shandong University, Shandong University, 324 Jingwu Rd, Jinan, 250021, Shandong, People's Republic of China. wgb7932596@hotmail.com.
authors.forename: Guangbin
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of MR, Shandong Medical Imaging Research Institute Affiliated to Shandong University, Shandong University, 324 Jingwu Rd, Jinan, 250021, Shandong, People's Republic of China.
authors.forename: Mansoor-Ul
authors.initials: MU
authors.lastname: Hasan
authors.affiliation: Department of MR, Shandong Medical Imaging Research Institute Affiliated to Shandong University, Shandong University, 324 Jingwu Rd, Jinan, 250021, Shandong, People's Republic of China.
authors.forename: Bin
authors.initials: B
authors.lastname: Yao
authors.affiliation: Department of MR, Shandong Medical Imaging Research Institute Affiliated to Shandong University, Shandong University, 324 Jingwu Rd, Jinan, 250021, Shandong, People's Republic of China.
authors.forename: Chao
authors.initials: C
authors.lastname: Wu
authors.affiliation: Department of Radiology, Shandong Chest Hospital, Jinan, 250021, Shandong, People's Republic of China.
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Philips Healthcare, Shanghai, People's Republic of China.
authors.forename: Weibo
authors.initials: W
authors.lastname: Chen
authors.affiliation: Philips Healthcare, Shanghai, People's Republic of China.
authors.forename: Queenie
authors.initials: Q
authors.lastname: Chan
authors.affiliation: Department of MR, Shandong Medical Imaging Research Institute Affiliated to Shandong University, Shandong University, 324 Jingwu Rd, Jinan, 250021, Shandong, People's Republic of China.
authors.forename: Lebin
authors.initials: L
authors.lastname: Wu
authors.affiliation: UT Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Avneesh
authors.initials: A
authors.lastname: Chhabra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006225:Hand / Q000294:innervation*; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000473:pathology*; D008875:Middle Aged; D015588:Observer Variation; D010525:Peripheral Nerves / Q000473:pathology; D010523:Peripheral Nervous System Diseases / Q000473:pathology*; D011446:Prospective Studies; D014459:Ulnar Nerve / Q000473:pathology*; D014953:Wrist / Q000294:innervation*; D014955:Wrist Joint / Q000473:pathology; D055815:Young Adult
keywords: Diffusion-weighted imaging; MR neurography; Median nerve; Ulnar nerve; Wrist