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Journal of Korean Neurosurgical Society 2001;30(9): 1120-1126.
The Value of MRI in Diagnosis of Peripheral Nerve Disorders.
Han Young Lee, Jang Chull Lee, Il Man Kim, Chang Young Lee, Eun Ik Son, Dong Won Kim, Man Bin Yim
1Department of Neurosurgery, Keimyung University School of Medicine, Taegu, Korea.
2Barundung Neurosurgery Clinic, Taegu, Korea.
The development of magnetic resonance neurography(MRN) has made it possible to produce high-resolution images of peripheral nerves themselves, as well as associated intraneural and extraneural lesions. We evaluated the clinical application and utility of high-resolution MRN techniques for the diagnosis and treatment of a variety of peripheral nerve disorder(PND)s. MATERIAL AND METHOD: MRN images were obtained using T1-weighted spin echo, T2-weighted fast spin echo with fat suppression, and short tau inversion recovery(STIR) fast spin-echo pulse sequences. Fifteen patients were studied, three with brachial plexus tumors, five with chronic entrapment syndromes, and seven with traumatic peripheral lesions. Ten patients underwent surgery.
In MRN with STIR sequences of axial and coronal imagings, signals of the peripheral nerves with various lesions were detected as fairly bright signals and were discerned from signals of the uninvolved nerves. Increased signal with proximal swelling and distal flattening of the median nerve were seen in all patients of carpal tunnel syndrome. Among the eight patients with brachial plexus injury or tumors, T2-weighted MRN showed increased signal intensity in involved roots in five, enhanced mass lesions in three, and traumatic pseudomeningocele in three. Other associated MRI findings were adjacent bony signal change, neuroma, root adhesion and denervated muscle atophy with signal change.
MRN with high-resolution imaging can be useful in the preoperative evaluation and surgical planning in patients with peripheral nerve lesions.
Key Words: Magnetic resonance neurography(MRN); Peripheral nerve disorder; Short tau inversion recovery(STIR); Brachial plexus Peripheral nerve injury
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