MRI Unit, Radiology Department, HT Médica, Jaén, Spain.
Clinic Scientist, Philips Healthcare, Madrid, Spain.
Semin Musculoskelet Radiol. 2022 Apr;26(2):93-104. doi: 10.1055/s-0042-1742753. Epub 2022 May 24.
Imaging evaluation of peripheral nerves (PNs) is challenging. Magnetic resonance imaging (MRI) and ultrasonography are the modalities of choice in the imaging assessment of PNs. Both conventional MRI pulse sequences and advanced techniques have important roles. Routine MR sequences are the workhorse, with the main goal to provide superb anatomical definition and identify focal or diffuse nerve T2 signal abnormalities. Selective techniques, such as three-dimensional (3D) cranial nerve imaging (CRANI) or 3D NerveVIEW, allow for a more detailed evaluation of normal and pathologic states. These conventional pulse sequences have a limited role in the comprehensive assessment of pathophysiologic and ultrastructural abnormalities of PNs. Advanced functional MR neurography sequences, such as diffusion tensor imaging tractography or T2 mapping, provide useful and robust quantitative parameters that can be useful in the assessment of PNs on a microscopic level. This article offers an overview of various technical parameters, pulse sequences, and protocols available in the imaging of PNs and provides tips on avoiding potential pitfalls.
外周神经(PNs)的影像学评估具有挑战性。磁共振成像(MRI)和超声是 PNs 影像学评估的首选方式。常规 MRI 脉冲序列和高级技术都有重要作用。常规 MR 序列是主力,主要目标是提供极好的解剖定义,并识别局灶性或弥漫性神经 T2 信号异常。选择性技术,如三维(3D)颅神经成像(CRANI)或 3D NerveVIEW,可更详细地评估正常和病理状态。这些常规脉冲序列在外周神经的病理生理和超微结构异常的综合评估中作用有限。高级功能 MRI 神经成像序列,如扩散张量成像纤维束追踪或 T2 映射,提供有用且稳健的定量参数,可在外周神经的微观水平评估中发挥作用。本文概述了 PNs 成像中各种技术参数、脉冲序列和方案,并提供了避免潜在陷阱的技巧。