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Kondo H, Suzuki T, Hayakawa K, Maeda A, Funahashi T, Kuroiwa T, Kawano Y, Iwamoto T, Fujita N. T2 magnetic resonance imaging mapping and morphology of the median nerve before and after surgery in carpal tunnel syndrome. Muscle Nerve 2024; 70:346-351. [PMID: 38924089 DOI: 10.1002/mus.28191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION/AIMS T2 magnetic resonance imaging (MRI) mapping has been applied to carpal tunnel syndrome (CTS) for quantitative assessment of the median nerve. However, quantitative changes in the median nerve before and after surgery using T2 MRI mapping remain unclear. We aimed to investigate whether pathological changes could be identified by pre- and postoperative T2 MRI mapping of the median nerve in CTS patients after open carpal tunnel release. METHODS This was a prospective study that measured median nerve T2 and cross-sectional area (CSA) values at the distal carpal tunnel, hamate bone, proximal carpal tunnel, and forearm levels pre- and postoperatively. Associations between T2, CSA, and nerve conduction latency were also evaluated. RESULTS A total of 36 patients with CTS (mean age, 64.5 ± 11.7 years) who underwent surgery were studied. The mean preoperative T2 values significantly decreased from 56.3 to 46.9 ms at the proximal carpal tunnel levels (p = .001), and from 52.4 to 48.7 ms at the hamate levels postoperatively (p = .04). Although there was a moderate association between preoperative T2 values at the distal carpal tunnel levels and distal motor latency values (r = -.46), other T2 values at all four carpal tunnel levels were not significantly associated with CSA or nerve conduction latency pre- or postoperatively. DISCUSSION T2 MRI mapping of the carpal tunnel suggested a decrease in nerve edema after surgery. T2 MRI mapping provides quantitative information on the median nerve before and after surgery.
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Affiliation(s)
- Harunori Kondo
- Department of Orthopedic Surgery, Fujita Health University, Toyoake, Aichi, Japan
| | - Taku Suzuki
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | | | - Atsushi Maeda
- Department of Orthopedic Surgery, Fujita Health University, Toyoake, Aichi, Japan
| | - Takuya Funahashi
- Department of Orthopedic Surgery, Fujita Health University, Toyoake, Aichi, Japan
| | - Takashi Kuroiwa
- Department of Orthopedic Surgery, Fujita Health University, Toyoake, Aichi, Japan
| | - Yusuke Kawano
- Department of Orthopedic Surgery, Fujita Health University, Toyoake, Aichi, Japan
| | - Takuji Iwamoto
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Nobuyuki Fujita
- Department of Orthopedic Surgery, Fujita Health University, Toyoake, Aichi, Japan
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Campbell GJ, Sneag DB, Queler SC, Lin Y, Li Q, Tan ET. Quantitative double echo steady state T2 mapping of upper extremity peripheral nerves and muscles. Front Neurol 2024; 15:1359033. [PMID: 38426170 PMCID: PMC10902120 DOI: 10.3389/fneur.2024.1359033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction T2 mapping can characterize peripheral neuropathy and muscle denervation due to axonal damage. Three-dimensional double echo steady-state (DESS) can simultaneously provide 3D qualitative information and T2 maps with equivalent spatial resolution. However, insufficient signal-to-noise ratio may bias DESS-T2 values. Deep learning reconstruction (DLR) techniques can reduce noise, and hence may improve quantitation of high-resolution DESS-T2. This study aims to (i) evaluate the effect of DLR methods on DESS-T2 values, and (ii) to evaluate the feasibility of using DESS-T2 maps to differentiate abnormal from normal nerves and muscles in the upper extremities, with abnormality as determined by electromyography. Methods and results Analysis of images from 25 subjects found that DLR decreased DESS-T2 values in abnormal muscles (DLR = 37.71 ± 9.11 msec, standard reconstruction = 38.56 ± 9.44 msec, p = 0.005) and normal muscles (DLR: 27.18 ± 6.34 msec, standard reconstruction: 27.58 ± 6.34 msec, p < 0.001) consistent with a noise reduction bias. Mean DESS-T2, both with and without DLR, was higher in abnormal nerves (abnormal = 75.99 ± 38.21 msec, normal = 35.10 ± 9.78 msec, p < 0.001) and muscles (abnormal = 37.71 ± 9.11 msec, normal = 27.18 ± 6.34 msec, p < 0.001). A higher DESS-T2 in muscle was associated with electromyography motor unit recruitment (p < 0.001). Discussion These results suggest that quantitative DESS-T2 is improved by DLR and can differentiate the nerves and muscles involved in peripheral neuropathies from those uninvolved.
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Affiliation(s)
- Gracyn J. Campbell
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, United States
| | - Darryl B. Sneag
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, United States
| | - Sophie C. Queler
- College of Medicine, Downstate Health Sciences University, Brooklyn, NY, United States
| | - Yenpo Lin
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, United States
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Qian Li
- Biostatistics Core, Hospital for Special Surgery, New York, NY, United States
| | - Ek T. Tan
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, United States
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Sveinsson B, Rowe OE, Stockmann JP, Park DJ, Lally PJ, Rosen MS, Barry RL, Eichler F, Rosen BR, Sadjadi R. Feasibility of simultaneous high-resolution anatomical and quantitative magnetic resonance imaging of sciatic nerves in patients with Charcot-Marie-Tooth type 1A (CMT1A) at 7T. Muscle Nerve 2022; 66:206-211. [PMID: 35621349 PMCID: PMC9308706 DOI: 10.1002/mus.27647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION/AIMS Magnetic resonance imaging (MRI) of peripheral nerves can provide image-based anatomical information and quantitative measurement. The aim of this pilot study was to investigate the feasibility of high-resolution anatomical and quantitative MRI assessment of sciatic nerve fascicles in patients with Charcot-Marie-Tooth (CMT) 1A using 7T field strength. METHODS Six patients with CMT1A underwent imaging on a high-gradient 7T MRI scanner using a 28-channel knee coil. Two high-resolution axial images were simultaneously acquired using a quantitative double-echo in steady-state (DESS) sequence. By comparing the two DESS echoes, T2 and apparent diffusion coefficient (ADC) maps were calculated. The cross-sectional areas and mean T2 and ADC were measured in individual fascicles of the tibial and fibular (peroneal) portions of the sciatic nerve at its bifurcation and 10 mm distally. Disease severity was measured using Charcot-Marie-Tooth Examination Score (CMTES) version 2 and compared to imaging findings. RESULTS We demonstrated the feasibility of 7T MRI of the proximal sciatic nerve in patients with CMT1A. Using the higher field, it was possible to measure individual bundles in the tibial and fibular divisions of the sciatic nerve. There was no apparent correlation between diffusion measures and disease severity in this small cohort. DISCUSSION This pilot study indicated that high-resolution MRI that allows for combined anatomical and quantitative imaging in one scan is feasible at 7T field strengths and can be used to investigate the microstructure of individual nerve fascicles.
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Affiliation(s)
- Bragi Sveinsson
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
| | - Olivia E Rowe
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
| | - Jason P Stockmann
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel J Park
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Peter J Lally
- Department of Brain Sciences, Imperial College London, London, UK
| | - Matthew S Rosen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
- Department of Physics, Harvard University, Cambridge, Massachusetts, USA
| | - Robert L Barry
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
- Harvard-Massachusetts Institute of Technology Health Sciences and Technology, Cambridge, Massachusetts, USA
| | - Florian Eichler
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Bruce R Rosen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
| | - Reza Sadjadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Funahasi T, Suzuki T, Hayakawa K, Nakane T, Maeda A, Kuroiwa T, Kawano Y, Iwamoto T, Fujita N. Visualization of the morphological changes in the median nerve after carpal tunnel release using three-dimensional magnetic resonance imaging. Eur Radiol 2022; 32:3016-3023. [DOI: 10.1007/s00330-021-08447-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/16/2021] [Accepted: 10/27/2021] [Indexed: 11/04/2022]
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