From the Departments of Radiology (B.J.H., K.R.P., B.B., P.P., R.Q.).
From the Departments of Radiology (B.J.H., K.R.P., B.B., P.P., R.Q.)
AJNR Am J Neuroradiol. 2018 Jan;39(1):177-183. doi: 10.3174/ajnr.A5437. Epub 2017 Nov 2.
Traumatic peripheral nerve injury is common and results in loss of function and/or neuropathic pain. MR neurography is a well-established technique for evaluating peripheral nerve anatomy and pathology. However, the Gd-DTPA enhancement characteristics of acutely injured peripheral nerves have not been fully examined. This study was performed to determine whether acutely crushed rat sciatic nerves demonstrate Gd-DTPA enhancement and, if so, to evaluate whether enhancement is affected by crush severity.
In 26 rats, the sciatic nerve was crushed with either surgical forceps (6- to 20-N compressive force) or a microvascular/microaneurysm clip (0.1-0.6 N). Animals were longitudinally imaged at 4.7T for up to 30 days after injury. T1WI, T2WI, and T1WI with Gd-DTPA were performed.
Forceps crush injury caused robust enhancement between days 3 and 21, while clip crush injury resulted in minimal-to-no enhancement. Enhancement after forceps injury peaked at 7 days and was seen a few millimeters proximal to, in the region of, and several centimeters distal to the site of crush injury. Enhancement after forceps injury was statistically significant compared with clip injury between days 3 and 7 ( < .04).
Gd-DTPA enhancement of peripheral nerves may only occur above a certain crush-severity threshold. This phenomenon may explain the intermittent observation of Gd-DTPA enhancement of peripheral nerves after traumatic injury. The observation of enhancement may be useful in judging the severity of injury after nerve trauma.
外伤性周围神经损伤很常见,会导致功能丧失和/或神经病理性疼痛。磁共振神经成像(MR 神经成像)是一种评估周围神经解剖结构和病理的成熟技术。然而,尚未充分研究急性外伤性周围神经的钆二乙烯五胺五乙酸(Gd-DTPA)增强特征。本研究旨在确定急性挤压大鼠坐骨神经是否表现出 Gd-DTPA 增强,如果是,评估增强是否受挤压严重程度的影响。
在 26 只大鼠中,使用手术钳(6-20-N 压缩力)或微血管/微动脉瘤夹(0.1-0.6-N)挤压坐骨神经。动物在损伤后 4.7T 进行纵向成像,最长可达 30 天。进行 T1WI、T2WI 和 T1WI 加 Gd-DTPA。
钳夹挤压伤在 3 天至 21 天之间引起强烈的增强,而微夹挤压伤则导致最小至无增强。钳夹损伤后的增强在 7 天达到峰值,在挤压损伤部位近端的几个毫米处、损伤区域和几厘米处的几个毫米处可见增强。与微夹损伤相比,钳夹损伤后的增强在第 3 天至第 7 天具有统计学意义(<0.04)。
周围神经的 Gd-DTPA 增强可能仅在一定的挤压严重程度阈值以上发生。这种现象可能解释了外伤性周围神经损伤后 Gd-DTPA 增强的间歇性观察。增强的观察可能有助于判断神经创伤后的损伤严重程度。