Synopsis

Keywords: Neuro: Nerves, Musculoskeletal: Muscular, Image acquisition: Sequences

Musculoskeletal nerve neuropathies, neuritis and palsies have often been diagnosed clinically and sent for MRI scans to investigate their appearance and if any other gross pathology abutting the nerves is a cause for the patient symptoms. For many years we have been able to visualize these nerves in their main branches, however the site of change can be extremely subtle in signal change and in most cases do not enhance after the administration of intravenous Gadolinium. Dedicated 3D Nerve sequences have changed diagnostic confidence in these cases and continued to evolve in sensitivity with improved sequence structure and parameters.

Musculoskeletal nerve neuropathies, neuritis and palsies have often been diagnosed clinically and sent for MRI scans to investigate their appearance and if any other gross pathology abutting the nerves is a cause for the patient symptoms. For many years we have been able to visualize these nerves in their main branches, however the site of change can be extremely subtle in signal change and in most cases do not enhance after the administration of intravenous Gadolinium. Dedicated 3D Nerve sequences which have a strong background suppression as well as blood flow suppression have changed diagnostic confidence in these cases and continued to evolve in sensitivity with improved sequence structure and parameters. We will look at the basics of these sequences and options to improve contrast and geometric resolution. We will also investigate the use of Gadolinium contrast and its effect on blood flow when utilizing the STIR based sequence. Since the introduction of these methods, sensitivity to nerve related injuries and long term neuropathies/neuritis have revolutionized the validation of clinically diagnosed cases and with early treatment, had improved therapeutic, interventional and surgical outcomes for patients.

Acknowledgements

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References

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