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Magnetic resonance imaging of the peripheral nervous system

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Abstract

The diagnostic work up of patients with peripheral neuropathy largely depends on clinical and electrophysiological investigations. In contrast to disorders of the CNS, magnetic resonance imaging (MRI) has not been widely used as a diagnostic tool in the PNS except for detection of nerve compressing mass lesions. Normal nerves appear isointense to the surrounding tissue on T1- and T2-weighted (w) MRIs, but upon injury the nerves become hyperintense and thus visible on T2-w MRI. These signal alterations can be exploited to diagnose nerve damage in vivo and to follow regeneration. In patients with peripheral nerve disorders, MRI has been especially useful in detecting focal intrinsic and extrinsic nerve lesions and may reveal treatable conditions even in the absence of gross electrophysiological alterations. This clinical review provides practical guidelines on the performance of nerve imaging by MRI and will focus on focal lesions exemplified by case presentations.

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Abbreviations

DTI:

Diffusion tensor imaging

MRI:

Magnetic resonance imaging

MRN:

Magnetic resonance neurography

T1-w:

T1-weighted

T2-w:

T2-weighted

TIRM:

Turbo inversion recovery magnitude

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Acknowledgments

Presented in part at the “Teaching Course Peripheral Neuropathies, 18th meeting of the European Neurological Society, June 8th 2008, Nice, France and at the IV. Neuromuscular Meeting, November 13th 2008, Havanna, Cuba sponsored by the ENS. Work of the authors cited in this review has been supported by the Research Fund of the State of Bavaria through the IZKF/Würzburg and by a research professorship for neuroimaging to M.B. (2003–2007) by the Department of Neurology sponsored by Schering Pharma AG, Berlin. We thank Profs. K. V. Toyka and L. Solymosi (Würzburg) for valuable comments on the manuscript and continuous support.

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Authors and Affiliations

  1. Department of Neurology, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany

    Guido Stoll

  2. Department Neuroradiology, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany

    Martin Bendszus & Mirko Pham

  3. Department Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany

    Jose Perez

  4. Department of Neuroradiology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany

    Martin Bendszus & Mirko Pham

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  1. Guido Stoll
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Correspondence to Guido Stoll.

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Stoll, G., Bendszus, M., Perez, J. et al. Magnetic resonance imaging of the peripheral nervous system. J Neurol 256, 1043–1051 (2009). https://doi.org/10.1007/s00415-009-5064-z

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