Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
Eur Radiol. 2019 Jul;29(7):3480-3487. doi: 10.1007/s00330-019-06145-4. Epub 2019 Mar 22.
Detection and pattern analysis of fascicular nerve hyperintensities in the T2-weighted image are the backbone of magnetic resonance neurography (MRN) as they may represent lesions of various etiologies. The aim of this study was to assess the prevalence of fascicular nerve hyperintensities in healthy individuals with regard to a potential association with age or cerebral white matter lesions.
Sixty volunteers without peripheral nerve diseases between the age of 20 and 80 underwent MRN (high-resolution T2-weighted) of upper (median, ulnar, radial) and lower (sciatic, tibial) extremity nerves and a fluid-attenuated inversion recovery (FLAIR) sequence of the brain. Presence of peripheral nerve hyperintensities and degree of cerebral white matter lesions were independently rated by two blinded readers and related to each other and to age. T test with Welch's correction was used for group comparisons. Spearman's correlation coefficients were reported for correlation analyses.
MR neurography revealed fascicular hyperintensities in 10 of 60 subjects (16.7%). Most frequently, they occurred in the sciatic nerve (8/60 subjects, 13.3%), less frequently in the tibial nerve at the lower leg and the median, ulnar, and radial nerves at the upper arm (1.7-5.0%). Mean age of subjects with nerve hyperintensities was higher than that of those without (60.6 years vs. 48.0 years, p = 0.038). There was only a weak correlation of nerve lesions with age and with cerebral white matter lesions, respectively.
Fascicular nerve hyperintensities may occur in healthy individuals and should therefore always be regarded in conjunction with the clinical context.
• MR neurography may reveal fascicular hyperintensities in peripheral nerves of healthy individuals. Fascicular hyperintensities occur predominantly in the sciatic nerve and older individuals. • Therefore, fascicular hyperintensities should only be interpreted as clearly pathologic in conjunction with the clinical context.
在 T2 加权图像中检测和分析神经束状高信号是磁共振神经成像（MRN）的基础，因为它们可能代表各种病因的病变。本研究旨在评估健康个体中神经束状高信号的发生率，以及其与年龄或脑白质病变之间的潜在关联。
60 名年龄在 20 岁至 80 岁之间、无周围神经疾病的志愿者接受了上肢（正中神经、尺神经、桡神经）和下肢（坐骨神经、胫神经）的高分辨率 T2 加权 MRN 和脑液体衰减反转恢复（FLAIR）序列检查。两名盲法观察者独立评估周围神经高信号的存在和脑白质病变的程度，并将其相互关联，并与年龄相关联。使用 Welch 校正的 t 检验进行组间比较。报告 Spearman 相关系数进行相关性分析。
MR 神经成像显示 60 名受试者中有 10 名（16.7%）存在神经束状高信号。最常见的是坐骨神经（8/60 例，13.3%），其次是小腿的胫神经和上臂的正中神经、尺神经和桡神经（1.7-5.0%）。有神经高信号的受试者的平均年龄高于无神经高信号的受试者（60.6 岁 vs. 48.0 岁，p=0.038）。神经病变与年龄和脑白质病变之间仅存在微弱的相关性。
健康个体中可能出现神经束状高信号，因此应始终结合临床情况进行考虑。
MR 神经成像可能会显示健康个体的周围神经出现神经束状高信号。神经束状高信号主要发生在坐骨神经和年龄较大的个体中。
因此，只有在结合临床情况的情况下，才能将神经束状高信号明确解释为病理性的。
