Sameer Shah1, Qun He1, Micheal Carl2, Justin Brown1, Mark Mahan3, Graeme M. Bydder1, and Nikolaus M. Szeverenyi1
1University of California, San Diego, San Diego, CA, United States, 2Global MR Applications & Workflow, General Electric, San Diego, CA, United States, 3Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, United States
Synopsis
The objective of this paper is to describe the
use of several new approaches for magnetic resonance (MR) imaging of peripheral
nerves. MR examinations were performed on fresh human
median, tibial and sciatic nerve samples, as well as cadaveric forearms at 3T
and/or 11.7T as well as one fresh human median nerve sample.
Application of MR techniques used elsewhere in the body,
and the use of MR microscopy show a variety of new imaging findings in
peripheral nerve. This approach is likely to improve understanding of the MR appearances
of peripheral nerve and lead to improved experimental and clinical studies.Introduction
This paper describes results from several new approaches
for MR imaging of peripheral nerves. These include magnetization transfer of
short T2 components, susceptibility and diffusion anisotropy in the
collagen components of nerve as well as differential contrast enhancement with
GdDTPA.
Methods
MR examinations were performed on fresh human median,
tibial and sciatic nerve samples and cadaveric forearms at 3T and/or 11.7 T. Pre and post Gd images were obtained on human
volunteers in a 3T clinical system. Ultrashort and zero echo time (UTE, ZTE), off-resonance
saturation contrast (OSC),
susceptibility weighted imaging, magic angle dipolar anisotropy imaging,
and diffusion weighted imaging was performed on samples with the 3T and/or the
11.7T system.
Results
Use of UTE pulse sequences produced high signal from
short and long T2 tissue components in nerve. The epineurium, perineurium
and endoneurium/neuronal fiber compartments were easily recognized.
Off-resonance saturation including magnetization transfer produced high short
T2 tissue contrast (Fig 1). Magic angle effects in different nerve tissue components
were demonstrated (Fig. 2). Obvious susceptibility differences between the perineurium
and surrounding tissues were evident (Fig. 3). Diffusion
contrast attributable to anisotropic restriction in collagen was seen in the
perineurium. In Fig. 4 the
perineurium is uniformly highlighted in (A), whereas in (B) only the vertical
medial and lateral components perpendicular to the sensitization gradient are
highlighted (arrow). In (C) the superior
and inferior components of the perineurium are highlighted (arrow). These are the regions perpendicular to the Gy
sensitization gradient. In (D) the perineurium is isointense with the
endoneurium/neuronal fiber component. Diffusion contrast was also apparent in both the epineurium and
endoneurium/neuronal fiber complex. Tractography showed directional differences
within different tissue components of nerves. Contrast enhancement was
separately seen in the epi-, peri and endoneurial/fiber complex of the median
nerve in vivo . Over time the epi- and perineurium signal differences
converged (Fig. 5). The rat sciatic nerve showed similar features to human nerve.
Fixation produced a reduction in T1 and T2 in each of the
neural components.
Discussion
Application of MR techniques used elsewhere in
the body, and the use of MR microscopy show a variety of new imaging findings
in peripheral nerve that have not been described previously
1-3. These approaches are likely to improve understanding of the MR
appearances of peripheral nerve and lead to improved experimental and clinical studies
Acknowledgements
No acknowledgement found.References
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