Seminars in musculoskeletal radiology
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Semin Musculoskelet Radiol · Apr 2015
ReviewThree-dimensional MR neurography of the lumbosacral plexus.
The lumbosacral (LS) plexus is a complicated network of nerves, and the complex anatomy is resolvable using high-resolution three-dimensional (3D) magnetic resonance neurography. This article focuses on 3D imaging evaluation of the anatomy and the pathology of various LS plexus branch nerves.
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MRI of the peripheral nerves continues to grow technologically and in clinical use. This article reviews the technological aspects and basic interpretation of high-resolution MR imaging of the upper extremity nerves. These techniques work with 1.5-, or preferably 3-T, scanners regardless of vendors. The article also includes selected pitfalls in the interpretation of upper extremity nerve MRI.
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Semin Musculoskelet Radiol · Apr 2015
ReviewCurrent MR neurography techniques and whole-body MR neurography.
MR neurography (MRN) techniques continue to evolve, leading to a better demonstration of peripheral nerve anatomy and pathology. This article discusses various technical perspectives and provides recommendations to obtain the best possible high-resolution imaging of the peripheral nerves in various areas of the body. We also discuss technical perspectives of whole-body MRN and its potential utility.
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MR neurography (MRN) has evolved to become a clinically useful imaging modality for evaluating nerve pathologies. Anatomically, nerves are often surrounded by fat and blood vessels, which appear bright on MR images impeding the conspicuity of nerve visualization. ⋯ These advancements enabled optimized imaging protocols for better visualization of the nerves. This review article discusses some of these technical advancements that enabled current MRN protocols in routine clinical imaging and certain research techniques that may facilitate nerve disorder characterization following interventions.
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Molecular and cellular imaging of neuropathic pain, utilizing the myriad of receptors and inflammatory mediators involved in nociceptive activity, is a promising approach toward objectively identifying peripheral pain generators. Neuropathic conditions arise from injured and inflamed nerves, which have been shown to elaborate several molecular and cellular elements that give rise to the neuropathic phenotype and can be exploited for imaging purposes. ⋯ By combining the sensitivity and specificity of molecular imaging with the high anatomical, spatial and contrast resolution afforded by computed tomography and MRI, radiologists can potentially identify sites of nerve injury or neuroinflammation that are implicated as peripheral pain drivers with greater accuracy and confidence. In addition to guiding therapy, these approaches will aid in new drug designs for analgesia and more individualized treatment options.