Musculoskeletal Imaging Division, Department of Radiology, University of Michigan, Ann Arbor, MI, United States.
Department of Surgery, Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, United States; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States.
J Plast Reconstr Aesthet Surg. 2024 Dec;99:47-54. doi: 10.1016/j.bjps.2024.09.017. Epub 2024 Sep 10.
To describe the MRI appearance of regenerative peripheral nerve interface (RPNI) and the potential association between the MRI appearance and RPNI revision.
A retrospective assessment was undertaken of the MRI appearance of RPNIs performed at our institution between 1/1/2010 and 7/29/2023 with clinical correlation.
Fourteen patients (8 men and 6 women, age range 31-80 years, median age 51 years) with technically adequate MRI of RPNIs were included in this study including 5 patients with below knee amputation with 5 tibial and 4 common peroneal nerves RPNI, 8 patients with above knee amputations (AKA) with sciatic RPNIs, and 1 patient following forequarter amputation with a brachial plexus RPNI. Two patients underwent revision RPNI surgery thrice (AKA-sciatic nerve) for a total of 6 RPNI revisions. On T1 weighted sequences, all RPNIs were isointense to the muscle and blended with the surrounding scar and muscle tissues whereas on T2 weighted sequences, all RPNIs were hyperintense in signal compared to the muscle. All but 1 RPNI underwent post contrast enhancement in variable patterns. No statistically significant difference in MRI appearance was found between RPNIs with or without a following RPNI revision surgery.
RPNI on MRI typically have a bright and intermediate signal on T2 and T1 weighted sequences, respectively, and typically undergo postcontrast enhancement in variable patterns without a statistically significant difference between the cases with and without follow-up RPNI revision. However, enhancement of RPNI should not be misconstrued as pathological.
描述再生周围神经接口（RPNI）的 MRI 表现，以及 MRI 表现与 RPNI 修正之间的潜在关联。
对我院于 2010 年 1 月 1 日至 2023 年 7 月 29 日期间进行的 RPNI 的 MRI 表现进行回顾性评估，并与临床资料进行相关性分析。
本研究共纳入 14 例患者（8 名男性，6 名女性；年龄 31-80 岁，中位年龄 51 岁），均有技术上足够的 RPNI 磁共振成像资料，包括 5 例膝下截肢患者的 5 例胫神经和 4 例腓总神经 RPNI、8 例膝上截肢患者的坐骨神经 RPNI，以及 1 例上肢截肢患者的臂丛神经 RPNI。2 例患者因 AKA-坐骨神经 RPNI 接受了 3 次 RPNI 修正手术，共进行了 6 次 RPNI 修正手术。在 T1 加权序列上，所有 RPNI 与肌肉等信号，与周围疤痕和肌肉组织混合；在 T2 加权序列上，所有 RPNI 信号均高于肌肉。除 1 例 RPNI 外，其余 RPNI 均呈不同模式的增强后信号。RPNI 有无后续修正手术之间的 MRI 表现无统计学差异。
RPNI 在 MRI 上通常在 T2 和 T1 加权序列上具有明亮和中等信号，并且通常呈不同模式的增强后信号，在有或没有后续 RPNI 修正的病例之间无统计学差异。然而，RPNI 的增强不应被误解为病理性的。
