1
|
Simultaneous Quantification of Anisotropic Microcirculation and Microstructure in Peripheral Nerve. J Clin Med 2022; 11:jcm11113036. [PMID: 35683424 PMCID: PMC9181650 DOI: 10.3390/jcm11113036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/16/2022] [Accepted: 05/25/2022] [Indexed: 02/04/2023] Open
Abstract
Peripheral nerve injury is a significant public health challenge, and perfusion in the nerve is a potential biomarker for assessing the injury severity and prognostic outlook. Here, we applied a novel formalism that combined intravoxel incoherent motion (IVIM) and diffusion tensor imaging (DTI) to simultaneously characterize anisotropic microcirculation and microstructure in the rat sciatic nerve. Comparison to postmortem measurements revealed that the in vivo IVIM-DTI signal contained a fast compartment (2.32 ± 0.04 × 10−3 mm2/s mean diffusivity, mean ± sem, n = 6, paired t test p < 0.01) that could be attributed to microcirculation in addition to a slower compartment that had similar mean diffusivity as the postmortem nerve (1.04 ± 0.01 vs. 0.96 ± 0.05 × 10−3 mm2/s, p > 0.05). Although further investigation and technical improvement are warranted, this preliminary study demonstrates both the feasibility and potential for applying the IVIM-DTI methodology to peripheral nerves for quantifying perfusion in the presence of anisotropic tissue microstructure.
Collapse
|
2
|
Koide K, Sugiyama A, Yokota H, Mukai H, Wang J, Nakamura K, Misawa S, Ito S, Kuwabara S. Nerve Hypertrophy and Altered Diffusion in Anti-Myelin-Associated Glycoprotein Neuropathy Detected by Brachial Plexus Magnetic Resonance Neurography. Eur Neurol 2021; 85:95-103. [PMID: 34583351 DOI: 10.1159/000519128] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/14/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study assessed the morphological changes and diffusion tensor imaging (DTI)-derived parameters of the brachial plexus using magnetic resonance neurography (MRN) in patients with anti-myelin-associated glycoprotein (anti-MAG) neuropathy. METHODS Eight patients with anti-MAG neuropathy underwent MRN of the brachial plexus with 3-dimensional (3D) short tau inversion recovery (STIR) and DTI sequences. Two neuroradiologists and a neurologist qualitatively assessed nerve hypertrophy on 3D STIR MRN. The cross-sectional area (CSA) of the nerve roots was measured. Quantitative analyses of fractional anisotropy (FA) and axial, radial, and mean diffusivity (AD, RD, and MD) were obtained after postprocessing on DTI and manual segmentation. RESULTS There was nerve hypertrophy in 37.5% of the patients with anti-MAG neuropathy. All patients with anti-MAG neuropathy with nerve hypertrophy were refractory to rituximab therapy. The CSA of the nerve roots was inversely correlated with FA and positively correlated with MD and RD. FA decreased in the nerve roots and inversely correlated with disease duration. CONCLUSIONS Nerve hypertrophy appears in the proximal portion of peripheral nerves, such as the brachial plexus, in patients with anti-MAG neuropathy. Altered diffusion in the nerve roots might be associated with the loss of myelin integrity due to the demyelination process in anti-MAG neuropathy.
Collapse
Affiliation(s)
- Kyosuke Koide
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan,
| | - Atsuhiko Sugiyama
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hajime Yokota
- Department of Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hiroki Mukai
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Jiaqi Wang
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Keigo Nakamura
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Sonoko Misawa
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shoichi Ito
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.,Department of Medical Education, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Satoshi Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| |
Collapse
|
3
|
Wan Q, Yu Y, Bao Y, Hu J, Wang P, Peng Y, Xia X, Liao Y, Liu J, Xie X, Li X. Evaluation of peripheral nerve acute crush injury in rabbits: comparison among diffusion kurtosis imaging, diffusion tensor imaging and electromyography. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2021; 35:291-299. [PMID: 34374905 DOI: 10.1007/s10334-021-00952-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 05/01/2021] [Accepted: 08/05/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Diffusion kurtosis imaging (DKI) has been proven to provide additional value for assessing many central nervous system diseases compared with conventional diffusion tensor imaging (DTI); however, whether it has the same value in peripheral nerve injury is unclear. This study aimed to investigate the performance of DKI, DTI, and electromyography (EMG) in evaluating peripheral nerve crush injury (PNCI) in rabbits. MATERIALS AND METHODS A total of 27 New Zealand white rabbits were selected to establish a PNCI model. Longitudinal DTI, DKI, and EMG were evaluated before surgery and 1 day, 3 days, 1 week, 2 weeks, 4 weeks, 6 weeks, and 8 weeks after surgery. At each time point, two rabbits were randomly selected for pathological examination. RESULTS The results showed that fractional anisotropy (FA) derived from both DKI and DTI demonstrated a significant difference between injured and control nerves at all time points (all P < 0.005) mean kurtosis of the injured nerve was lower than that on the control side after 2-8 weeks (all P < 0.05). No statistically significant difference was found in radial kurtosis, axial kurtosis, and apparent diffusion coefficient at almost every time point. The difference in compound muscle action potential (CMAP) of the bilateral gastrocnemius at each time point was statistically significant (all P < 0.001). CONCLUSIONS CMAP was a sensitive and reliable method to assess acute PNCI without being affected by perineural edema. DKI may not be superior to DTI in evaluating peripheral nerves, DTI with a shorter scanning time was preferred as an effective choice for evaluating acute peripheral nerve traumatic injury.
Collapse
Affiliation(s)
- Qi Wan
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No. 151, Guangzhou, 510120, China
| | - Yudong Yu
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No. 151, Guangzhou, 510120, China.,Department of Radiology, Huizhou Central People's Hospital, Huizhou, China
| | - Yingying Bao
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No. 151, Guangzhou, 510120, China
| | - Jianfeng Hu
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No. 151, Guangzhou, 510120, China
| | - Peng Wang
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No. 151, Guangzhou, 510120, China
| | - Yu Peng
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No. 151, Guangzhou, 510120, China
| | - Xiaoying Xia
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No. 151, Guangzhou, 510120, China
| | | | - Jieqiong Liu
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No. 151, Guangzhou, 510120, China
| | - Xiaobin Xie
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No. 151, Guangzhou, 510120, China
| | - Xinchun Li
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No. 151, Guangzhou, 510120, China.
| |
Collapse
|
4
|
Walker MR, Zhong J, Waspe AC, Piorkowska K, Nguyen LN, Anastakis DJ, Drake JM, Hodaie M. Peripheral Nerve Focused Ultrasound Lesioning-Visualization and Assessment Using Diffusion Weighted Imaging. Front Neurol 2021; 12:673060. [PMID: 34305786 PMCID: PMC8299784 DOI: 10.3389/fneur.2021.673060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/18/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Magnetic resonance-guided focused ultrasound (MRgFUS) is a non-invasive targeted tissue ablation technique that can be applied to the nervous system. Diffusion weighted imaging (DWI) can visualize and evaluate nervous system microstructure. Tractography algorithms can reconstruct fiber bundles which can be used for treatment navigation and diffusion tensor imaging (DTI) metrics permit the quantitative assessment of nerve microstructure in vivo. There is a need for imaging tools to aid in the visualization and quantitative assessment of treatment-related nerve changes in MRgFUS. We present a method of peripheral nerve tract reconstruction and use DTI metrics to evaluate the MRgFUS treatment effect. Materials and Methods: MRgFUS was applied bilaterally to the sciatic nerves in 6 piglets (12 nerves total). T1-weighted and diffusion images were acquired before and after treatment. Tensor-based and constrained spherical deconvolution (CSD) tractography algorithms were used to reconstruct the nerves. DTI metrics of fractional anisotropy (FA), and mean (MD), axial (AD), and radial diffusivities (RD) were measured to assess acute (<1-2 h) treatment effects. Temperature was measured in vivo via MR thermometry. Histological data was collected for lesion assessment. Results: The sciatic nerves were successfully reconstructed in all subjects. Tract disruption was observed after treatment using both CSD and tensor models. DTI metrics in the targeted nerve segments showed significantly decreased FA and increased MD, AD, and RD. Transducer output power was positively correlated with lesion volume and temperature and negatively correlated with MD, AD, and RD. No correlations were observed between FA and other measured parameters. Conclusions: DWI and tractography are effective tools for visualizing peripheral nerve segments for targeting in non-invasive surgical methods and for assessing the microstructural changes that occur following MRgFUS treatment.
Collapse
Affiliation(s)
- Matthew R Walker
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Division of Brain, Imaging & Behaviour, Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Jidan Zhong
- Division of Brain, Imaging & Behaviour, Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Adam C Waspe
- Centre for Image Guided Innovation and Therapeutic Intervention, Hospital for Sick Children, Toronto, ON, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Karolina Piorkowska
- Centre for Image Guided Innovation and Therapeutic Intervention, Hospital for Sick Children, Toronto, ON, Canada
| | - Lananh N Nguyen
- Laboratory Medicine Program, University Health Network and University of Toronto, Toronto, ON, Canada
| | - Dimitri J Anastakis
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Division of Brain, Imaging & Behaviour, Krembil Research Institute, University Health Network, Toronto, ON, Canada.,Department of Surgery, Toronto Western Hospital, University Health Network and University of Toronto, Toronto, ON, Canada
| | - James M Drake
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Centre for Image Guided Innovation and Therapeutic Intervention, Hospital for Sick Children, Toronto, ON, Canada.,Department of Neurosurgery, Hospital for Sick Children, Toronto, ON, Canada
| | - Mojgan Hodaie
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Division of Brain, Imaging & Behaviour, Krembil Research Institute, University Health Network, Toronto, ON, Canada.,Department of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| |
Collapse
|
5
|
Farinas AF, Pollins AC, Stephanides M, O’Neill D, Al-Kassis S, Esteve IVM, Colazo JM, Keller PR, Rankin T, Wormer BA, Kaoutzanis C, Dortch RD, Thayer WP. Diffusion tensor tractography to visualize axonal outgrowth and regeneration in a 4-cm reverse autograft sciatic nerve rabbit injury model. Neurol Res 2019; 41:257-264. [PMID: 30582740 PMCID: PMC6435384 DOI: 10.1080/01616412.2018.1554284] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 11/24/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND Diffusion tensor tractography (DTT) has recently been shown to accurately detect nerve injury and regeneration. This study assesses whether 7-tesla (7T) DTT imaging is a viable modality to observe axonal outgrowth in a 4 cm rabbit sciatic nerve injury model fixed by a reverse autograft (RA) surgical technique. METHODS Transection injury of unilateral sciatic nerve (4 cm long) was performed in 25 rabbits and repaired using a RA surgical technique. Analysis of the nerve autograft was performed at 3, 6, and 11 weeks postoperatively and compared to normal contralateral sciatic nerve, used as control group. High-resolution DTT from ex vivo sciatic nerves were obtained using 3D diffusion-weighted spin-echo acquisitions at 7-T. Total axons and motor and sensory axons were counted at defined lengths along the graft. RESULTS At 11 weeks, histologically, the total axon count of the RA group was equivalent to the contralateral uninjured nerve control group. Similarly, by qualitative DTT visualization, the 11-week RA group showed increased fiber tracts compared to the 3 and 6 weeks counterparts. Upon immunohistochemical evaluation, 11-week motor axon counts did not significantly differ between RA and control; but significantly decreased sensory axon counts remained. Nerves explanted at 3 weeks and 6 weeks showed decreased motor and sensory axon counts. DISCUSSION 7-T DTT is an effective imaging modality that may be used qualitatively to visualize axonal outgrowth and regeneration. This has implications for the development of technology that non-invasively monitors peripheral nerve regeneration in a variety of clinical settings.
Collapse
Affiliation(s)
- Angel F. Farinas
- Vanderbilt University Medical Center, Department of Plastic
Surgery, Nashville, TN
| | - Alonda C. Pollins
- Vanderbilt University Medical Center, Department of Plastic
Surgery, Nashville, TN
| | | | - Dillon O’Neill
- University of Utah, Department of Orthopedics, Salt Lake
City, UT
| | - Salam Al-Kassis
- Vanderbilt University Medical Center, Department of Plastic
Surgery, Nashville, TN
| | - Isaac V. Manzanera Esteve
- Vanderbilt University Medical Center, Department Radiology
and Radiological Sciences, Nashville, TN
- Vanderbilt University Medical Center, Institute of Imaging
Science, Nashville, TN
| | | | | | - Timothy Rankin
- Vanderbilt University Medical Center, Department of Plastic
Surgery, Nashville, TN
| | - Blair A. Wormer
- Vanderbilt University Medical Center, Department of Plastic
Surgery, Nashville, TN
| | | | - Richard D. Dortch
- Vanderbilt University, Department of Biomedical
Engineering, Nashville, TN
- Vanderbilt University Medical Center, Department Radiology
and Radiological Sciences, Nashville, TN
- Vanderbilt University Medical Center, Institute of Imaging
Science, Nashville, TN
| | - Wesley P. Thayer
- Vanderbilt University Medical Center, Department of Plastic
Surgery, Nashville, TN
- Vanderbilt University, Department of Biomedical
Engineering, Nashville, TN
| |
Collapse
|
6
|
Martín Noguerol T, Barousse R, Gómez Cabrera M, Socolovsky M, Bencardino JT, Luna A. Functional MR Neurography in Evaluation of Peripheral Nerve Trauma and Postsurgical Assessment. Radiographics 2019; 39:427-446. [DOI: 10.1148/rg.2019180112] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
7
|
Evaluation of two collagen conduits and autograft in rabbit sciatic nerve regeneration with quantitative magnetic resonance DTI, electrophysiology, and histology. Eur Radiol Exp 2018; 2:19. [PMID: 30148252 PMCID: PMC6091702 DOI: 10.1186/s41747-018-0049-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 05/24/2018] [Indexed: 12/18/2022] Open
Abstract
Background We compared different surgical techniques for nerve regeneration in a rabbit sciatic nerve gap model using magnetic resonance diffusion tensor imaging (DTI), electrophysiology, limb function, and histology. Methods A total of 24 male New Zealand white rabbits were randomized into three groups: autograft (n = 8), hollow conduit (n = 8), and collagen-filled conduit (n = 8). A 10-mm segment of the rabbit proximal sciatic nerve was cut, and autograft or collagen conduit was used to bridge the gap. DTI on a 3-T system was performed preoperatively and 13 weeks after surgery using the contralateral, nonoperated nerve as a control. Results Overall, autograft performed better compared with both conduit groups. Differences in axonal diameter were significant (autograft > hollow conduit > collagen-filled conduit) at 13 weeks (autograft vs. hollow conduit, p = 0.001, and hollow conduit vs. collagen-filled conduit, p < 0.001). Significant group differences were found for axial diffusivity but not for any of the other DTI metrics (autograft > hollow conduit > collagen-filled conduit) (autograft vs. hollow conduit, p = 0.001 and hollow conduit vs. collagen-filled conduit, p = 0.021). As compared with hollow conduit (autograft > collagen-filled conduit > hollow conduit), collagen-filled conduit animals demonstrated a nonsignificant increased maximum tetanic force. Conclusions Autograft-treated rabbits demonstrated improved sciatic nerve regeneration compared with collagen-filled and hollow conduits as assessed by histologic, functional, and DTI parameters at 13 weeks.
Collapse
|
8
|
Budde MD, Skinner NP. Diffusion MRI in acute nervous system injury. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2018; 292:137-148. [PMID: 29773299 DOI: 10.1016/j.jmr.2018.04.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 04/06/2018] [Accepted: 04/27/2018] [Indexed: 06/08/2023]
Abstract
Diffusion weighted magnetic resonance imaging (DWI) and related techniques such as diffusion tensor imaging (DTI) are uniquely sensitive to the microstructure of the brain and spinal cord. In the acute aftermath of nervous system injury, for example, DWI reveals changes caused by injury that remains invisible on other MRI contrasts such as T2-weighted imaging. This ability has led to a demonstrated clinical utility in cerebral ischemia. However, despite strong promise in preclinical models and research settings, DWI has not been as readily adopted for other acute injuries such as traumatic spinal cord, brain, or peripheral nerve injury. Furthermore, the precise biophysical mechanisms that underlie DWI and DTI changes are not fully understood. In this report, we review the DWI and DTI changes that occur in acute neurological injury of cerebral ischemia, spinal cord injury, traumatic brain injury, and peripheral nerve injury. Their associations with the underlying biology are examined with an emphasis on the role of acute axon and dendrite beading. Lastly, emerging DWI techniques to overcome the limitations of DTI are discussed as these may offer the needed improvements to translate to clinical settings.
Collapse
Affiliation(s)
- Matthew D Budde
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States.
| | - Nathan P Skinner
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States; Medical Scientist Training Program, Medical College of Wisconsin, Milwaukee, WI, United States
| |
Collapse
|
9
|
Rouchy RC, Attyé A, Medici M, Renard F, Kastler A, Grand S, Tropres I, Righini CA, Krainik A. Facial nerve tractography: A new tool for the detection of perineural spread in parotid cancers. Eur Radiol 2018; 28:3861-3871. [PMID: 29633003 DOI: 10.1007/s00330-018-5318-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 12/29/2017] [Accepted: 01/09/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To determine whether facial nerve MR tractography is useful in detecting PeriNeural Spread in parotid cancers. METHODS Forty-five participants were enrolled. Thirty patients with surgically managed parotid tumors (15 malignant, 15 benign) were compared with 15 healthy volunteers. All of them had undergone 3T-MRI with diffusion acquisition and post-processing constrained spherical deconvolution-based tractography. Parameters of diffusion-weighted sequences were b-value 1,000 s/mm2, 32 directions. Two radiologists performed a blinded visual reading of tractographic maps and graded the facial nerve average pathlength and fractional anisotropy (FA). We also compared diagnostic accuracy of tractography with morphological MRI sequences to detect PeriNeural Spread. Non-parametric methods were used. RESULTS Average pathlength was significantly higher in cases with PeriNeural Spread (39.86 mm [Quartile1: 36.27; Quartile3: 51.19]) versus cases without (16.23 mm [12.90; 24.90]), p<0.001. The threshold above which there was a significant association with PeriNeural Spread was set at 27.36 mm (Se: 100%; Sp: 84%; AUC: 0.96, 95% CI 0.904-1). There were no significant differences in FA between groups. Tractography map visual analyses directly displayed PeriNeural Spread in distal neural ramifications with sensitivity of 75%, versus 50% using morphological sequences. CONCLUSIONS Tractography could be used to identify facial nerve PeriNeural Spread by parotid cancers. KEY POINTS • Tractography could detect facial nerve PeriNeural Spread in parotid cancers. • The average pathlength parameter is increased in case of PeriNeural Spread. • Tractography could map PeriNeural Spread more precisely than conventional imaging.
Collapse
Affiliation(s)
- René-Charles Rouchy
- Department of Neuroradiology and MRI, Grenoble Alpes University Hospital - SFR RMN Neurosciences, F-38043, Grenoble, Cedex 9, France. .,University of Grenoble Alpes, IRMaGe, F-38000, Grenoble, France.
| | - Arnaud Attyé
- Department of Neuroradiology and MRI, Grenoble Alpes University Hospital - SFR RMN Neurosciences, F-38043, Grenoble, Cedex 9, France.,University of Grenoble Alpes, IRMaGe, F-38000, Grenoble, France
| | - Maud Medici
- Clinical Investigation Centre 1406 - Innovative Technology, National Institute of Health and Medical Research, Grenoble, France.,Public Health Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Félix Renard
- University of Grenoble Alpes, IRMaGe, F-38000, Grenoble, France
| | - Adrian Kastler
- Department of Neuroradiology and MRI, Grenoble Alpes University Hospital - SFR RMN Neurosciences, F-38043, Grenoble, Cedex 9, France.,University of Grenoble Alpes, IRMaGe, F-38000, Grenoble, France
| | - Sylvie Grand
- Department of Neuroradiology and MRI, Grenoble Alpes University Hospital - SFR RMN Neurosciences, F-38043, Grenoble, Cedex 9, France.,University of Grenoble Alpes, IRMaGe, F-38000, Grenoble, France
| | - Irène Tropres
- University of Grenoble Alpes, IRMaGe, F-38000, Grenoble, France.,IRMaGe, Inserm US 17, CNRS UMS 3552, Grenoble, France
| | | | - Alexandre Krainik
- Department of Neuroradiology and MRI, Grenoble Alpes University Hospital - SFR RMN Neurosciences, F-38043, Grenoble, Cedex 9, France.,University of Grenoble Alpes, IRMaGe, F-38000, Grenoble, France
| |
Collapse
|
10
|
Wu W, Niu Y, Kong X, Liu D, Long X, Shu S, Su X, Wang B, Liu X, Ma Y, Wang L. Application of diffusion tensor imaging in quantitatively monitoring chronic constriction injury of rabbit sciatic nerves: correlation with histological and functional changes. Br J Radiol 2017; 91:20170414. [PMID: 29166135 DOI: 10.1259/bjr.20170414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To investigate the potential of diffusion tensor imaging (DTI) in quantitatively monitoring chronic constriction injuri (CCI) of sciatic nerves and to analyse the association of DTI parameters with nerve histology and limb function. METHODS CCI was created on sciatic nerves in the right hind legs of 20 rabbits with the left as control. DTI parameters-fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusivity (AD) and radial diffusivity (RD)-and limb function were longitudinally evaluated. Pathology analysis was performed on day 3 (d3), week 1 (w1), 2, 4, 6, 8 and 10. RESULTS FA of the constricted nerves decreased on d3 (0.316 ± 0.044) and increased from w1 to w10 (0.331 ± 0.018, 0.354 ± 0.044, 0.375 ± 0.015, 0.394 ± 0.020, 0.42 ± 0.03 and 0.464 ± 0.039). ADC increased on d3 until w2 (1.502 ± 0.126, 1.462 ± 0.058 and 1.473 ± 0.124 × 10-3 mm2 s-1) and decreased to normal from w4 to w10 (1.356 ± 0.129, 1.375 ± 0.107, 1.290 ± 0.064 and 1.298 ± 0.026 × 10-3 mm2 s-1). AD decreased and stayed low from d3 to w10 (2.042 ± 0.160, 2.005 ± 0.095, 2.057 ± 0.124, 1.952 ± 0.213, 1.988 ± 0.180, 1.947 ± 0.106 and 2.097 ± 0.114). RD increased on d3 (1.233 ± 0.152) and declined from w1 to w10 (1.19 ± 0.06, 1.181 ± 0.14, 1.071 ± 0.102, 1.068 ± 0.084, 0.961 ± 0.063 and 0.923 ± 0.058). FA, ADC and RD correlated significantly with limb functional scores (all Ps < 0.0001) and their changes were associated with histological changes. CONCLUSION FA, ADC and RD are promising to monitor CCI. AD may be a stable indicator for injury. Histological changes, oedema, axon loss and demyelination, and fibrosis, accompanied the changes of these parameters. Advances in knowledge: DTI parameters can detect and monitor acute and chronic changes after nerve compression.
Collapse
Affiliation(s)
- Wenjun Wu
- 1 Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Yanfeng Niu
- 2 Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Xiangquan Kong
- 1 Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Dingxi Liu
- 1 Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Xi Long
- 1 Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Shenglei Shu
- 1 Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Xiaoyun Su
- 1 Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Bing Wang
- 1 Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Xiaoming Liu
- 1 Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Yamei Ma
- 1 Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Lixia Wang
- 1 Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| |
Collapse
|
11
|
Wako Y, Nakamura J, Eguchi Y, Hagiwara S, Miura M, Kawarai Y, Sugano M, Nawata K, Yoshino K, Toguchi Y, Masuda Y, Matsumoto K, Suzuki T, Orita S, Ohtori S. Diffusion tensor imaging and tractography of the sciatic and femoral nerves in healthy volunteers at 3T. J Orthop Surg Res 2017; 12:184. [PMID: 29187253 PMCID: PMC5707804 DOI: 10.1186/s13018-017-0690-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 11/19/2017] [Indexed: 11/10/2022] Open
Abstract
Background The aim was to clarify the normal fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the sciatic and femoral nerves at the level of the hip joint and to visualize the neural tracts with diffusion tensor imaging (DTI). Methods Twenty-four healthy volunteers (12 men and 12 women, age 20–29 years) underwent DTI for visualization with tractography and quantification of FA and ADC values on a 3 Tesla MRI (b value = 800 s/mm2, motion probing gradient, 11 directions, time to repeat/echo time = 9000/72.6 ms, axial slice orientation, slice thickness = 3.0 mm with no inter-slice gap, field of view = 320 × 320 mm, 96 × 192 matrix, 75 slices, number of acquisitions = 4). Regions of interest in the sciatic nerve were defined at the femoral head, the S1 root, and the midpoint levels. The femoral nerve was evaluated at 3–4 cm proximal to the femoral head level. Results The tractography of the sciatic and femoral nerves were visualized in all participants. The mean FA values of the sciatic nerve were increased distally from the S1 root level, through the midpoint, and to the femoral head level (0.314, 0.446, 0.567, p = 0.001, respectively). The mean FA values of the femoral nerve were 0.565. The mean ADC values of the sciatic nerves were significantly lower in the S1 root level than in the midpoint and the femoral head level (1.481, 1.602, 1.591 × 10−3 × 10−3 mm2/s, p = 0.001, respectively). The ADC values of the femoral nerve were 1.439 × 10−3 mm2/s. FA and ADC values showed moderate to substantial inter- and intra-observer reliability without significant differences in gender or laterality. Conclusion Visualization and quantification of the sciatic and femoral nerves simultaneously around the hip joint were achieved in healthy young volunteers with DTI. Clinical application of DTI is expected to contribute to hip pain research.
Collapse
Affiliation(s)
- Yasushi Wako
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba, 260-8677, Japan.
| | - Junichi Nakamura
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba, 260-8677, Japan
| | - Yawara Eguchi
- Department of Orthopedic Surgery, National Hospital Organization Shimoshizu National Hospital, 934-5, Shikawatashi, Yotsukaido city, Chiba, 284-0003, Japan
| | - Shigeo Hagiwara
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba, 260-8677, Japan
| | - Michiaki Miura
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba, 260-8677, Japan
| | - Yuya Kawarai
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba, 260-8677, Japan
| | - Masahiko Sugano
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba, 260-8677, Japan
| | - Kento Nawata
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba, 260-8677, Japan
| | - Kensuke Yoshino
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba, 260-8677, Japan
| | - Yasunari Toguchi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba, 260-8677, Japan
| | - Yoshitada Masuda
- Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba, 260-8677, Japan
| | - Koji Matsumoto
- Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba, 260-8677, Japan
| | - Takane Suzuki
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba, 260-8677, Japan
| | - Sumihisa Orita
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba, 260-8677, Japan
| | - Seiji Ohtori
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba city, Chiba, 260-8677, Japan
| |
Collapse
|
12
|
Zhang J, Zhang F, Xiao F, Xiong Z, Liu D, Hua T, Indima N, Tang G. Quantitative Evaluation of the Compressed L5 and S1 Nerve Roots in Unilateral Lumbar Disc Herniation by Using Diffusion Tensor Imaging. Clin Neuroradiol 2017; 28:529-537. [DOI: 10.1007/s00062-017-0621-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 08/03/2017] [Indexed: 02/06/2023]
|
13
|
Martín Noguerol T, Barousse R, Socolovsky M, Luna A. Quantitative magnetic resonance (MR) neurography for evaluation of peripheral nerves and plexus injuries. Quant Imaging Med Surg 2017; 7:398-421. [PMID: 28932698 DOI: 10.21037/qims.2017.08.01] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Traumatic conditions of peripheral nerves and plexus have been classically evaluated by morphological imaging techniques and electrophysiological tests. New magnetic resonance imaging (MRI) studies based on 3D fat-suppressed techniques are providing high accuracy for peripheral nerve injury evaluation from a qualitative point of view. However, these techniques do not provide quantitative information. Diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) are functional MRI techniques that are able to evaluate and quantify the movement of water molecules within different biological structures. These techniques have been successfully applied in other anatomical areas, especially in the assessment of central nervous system, and now are being imported, with promising results for peripheral nerve and plexus evaluation. DWI and DTI allow performing a qualitative and quantitative peripheral nerve analysis, providing valuable pathophysiological information about functional integrity of these structures. In the field of trauma and peripheral nerve or plexus injury, several derived parameters from DWI and DTI studies such as apparent diffusion coefficient (ADC) or fractional anisotropy (FA) among others, can be used as potential biomarkers of neural damage providing information about fiber organization, axonal flow or myelin integrity. A proper knowledge of physical basis of these techniques and their limitations is important for an optimal interpretation of the imaging findings and derived data. In this paper, a comprehensive review of the potential applications of DWI and DTI neurographic studies is performed with a focus on traumatic conditions, including main nerve entrapment syndromes in both peripheral nerves and brachial or lumbar plexus.
Collapse
Affiliation(s)
| | - Rafael Barousse
- Peripheral Nerve and Plexus Department, Centro Rossi, Buenos Aires, Argentina
| | - Mariano Socolovsky
- Peripheral Nerve and Plexus Surgery Unit, Department of Neurosurgery, University of Buenos Aires School of Medicine, Buenos Aires, Argentina
| | - Antonio Luna
- MRI Unit, Neuroradiology Section, Clínica Las Nieves, SERCOSA, Health Time, Jaén, Spain.,Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
14
|
Stacy MR, Dearth CL. Multimodality Imaging Approaches for Evaluating Traumatic Extremity Injuries: Implications for Military Medicine. Adv Wound Care (New Rochelle) 2017; 6:241-251. [PMID: 28736684 DOI: 10.1089/wound.2016.0716] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 12/22/2016] [Indexed: 01/08/2023] Open
Abstract
Significance: Military service members are susceptible to traumatic extremity injuries that often result in limb loss. Tremendous efforts have been made to improve medical treatment that supports residual limb function and health. Despite recent improvements in treatment and novel prosthetic devices, many patients experience a wide range of clinical problems within residual limbs that can negatively impact the progress of rehabilitation programs while also impairing functional capacity and overall quality of life. Recent Advances: In addition to existing standard imaging modalities that are used for clinical evaluation of patients suffering from traumatic extremity injury, novel noninvasive imaging techniques are in development that may facilitate rapid and sensitive assessment of various aspects of traumatic extremity injuries and residual limb health. Critical Issues: Despite recent advances, there remains a clinical need for noninvasive quantitative imaging techniques that are capable of providing rapid objective assessments of residual limb health at the time of initial presentation as well as after various forms of medical treatment. Future Directions: Ongoing development of imaging techniques that allow for assessment of anatomical and physiological characteristics of extremities exposed to traumatic injury should greatly enhance the quality of patient care and assist in optimizing clinical outcomes.
Collapse
Affiliation(s)
- Mitchel R. Stacy
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Christopher L. Dearth
- DOD-VA Extremity Trauma and Amputation Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland
- Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland
- Regenerative Biosciences Laboratory, Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| |
Collapse
|
15
|
Agnollitto PM, Chu MWK, Simão MN, Nogueira-Barbosa MH. Sciatic neuropathy: findings on magnetic resonance neurography. Radiol Bras 2017; 50:190-196. [PMID: 28670031 PMCID: PMC5487234 DOI: 10.1590/0100-3984.2015.0205] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
Injuries of the sciatic nerve are common causes of pain and limitation in the
lower limbs. Due to its particular anatomy and its long course, the sciatic
nerve is often involved in diseases of the pelvis or leg. In recent years,
magnetic resonance neurography has become established as an important tool for
the study of peripheral nerves and can be widely applied to the study of the
sciatic nerve. Therefore, detailed knowledge of its anatomy and of the most
prevalent diseases affecting it is essential to maximizing the accuracy of
diagnostic imaging.
Collapse
Affiliation(s)
- Paulo Moraes Agnollitto
- MD, Attending Physician in the Division of Radiology of the Department of Clinical Medicine at Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | | | - Marcelo Novelino Simão
- PhD, Attending Physician in the Division of Radiology of the Department of Clinical Medicine at Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Marcello Henrique Nogueira-Barbosa
- Tenured Associate Professor in the Division of Radiology of the Department of Clinical Medicine at Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| |
Collapse
|
16
|
Zheng CS, Zhang X, Chen YY, Zhang F, Duan XH, Chen MW, Lu LJ, Shen J. Assessment of the synergic effect of immunomodulation on nerve repair using multiparametric magnetic resonance imaging. Muscle Nerve 2017; 57:E38-E45. [PMID: 28445921 DOI: 10.1002/mus.25674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 04/05/2017] [Accepted: 04/23/2017] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The immune system plays a pivotal role in nerve injury. The aim of this study was to determine the role of multiparametric magnetic resonance imaging (MRI) in evaluation of the synergic effect of immunomodulation on nerve regeneration in neurotmesis. METHODS Rats with sciatic nerve neurotmesis and surgical repair underwent serial multiparametric MR examinations over an 8-week period after subepineurial microinjection of lipopolysaccharide (LPS) and subsequent subcutaneous injection of FK506 or subepineurial microinjection of LPS or phosphate-buffered saline (PBS) alone. RESULTS Nerves treated with immunomodulation showed more prominent regeneration than those treated with LPS or PBS alone and more rapid restoration toward normal T2, fractional anisotropy (FA), and radial diffusivity (RD) values than nerves injected with LPS or PBS. DISCUSSION Nerves treated with immunomodulation exert synergic beneficial effects on nerve regeneration that can be predicted by T2 measurements and FA and RD values. Muscle Nerve 57: E38-E45, 2018.
Collapse
Affiliation(s)
- Chu-Shan Zheng
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, 510120, Guangdong, China
| | - Xiang Zhang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, 510120, Guangdong, China
| | - Yue-Yao Chen
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, 510120, Guangdong, China
| | - Fang Zhang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, 510120, Guangdong, China
| | - Xiao-Hui Duan
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, 510120, Guangdong, China
| | - Mei-Wei Chen
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, 510120, Guangdong, China
| | - Lie-Jing Lu
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, 510120, Guangdong, China
| | - Jun Shen
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, 510120, Guangdong, China
| |
Collapse
|
17
|
White matter alterations in college football players: a longitudinal diffusion tensor imaging study. Brain Imaging Behav 2017; 12:44-53. [DOI: 10.1007/s11682-017-9672-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
18
|
Chen YY, Zhang X, Lin XF, Zhang F, Duan XH, Zheng CS, Chen MW, Wang DY, Zeng WK, Shen J. DTI metrics can be used as biomarkers to determine the therapeutic effect of stem cells in acute peripheral nerve injury. J Magn Reson Imaging 2016; 45:855-862. [PMID: 27448779 DOI: 10.1002/jmri.25395] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 07/05/2016] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To determine the role of diffusion tensor imaging (DTI) metrics as biomarkers for the therapeutic effects of mesenchymal stem cells (MSCs) in acute peripheral nerve injury. MATERIALS AND METHODS Forty-four adult rats received subepineurial microinjection of MSCs (n = 22) or phosphate buffered saline (PBS, n = 22) 1 week after the sciatic nerve trunk crush injury. Sequential fat-suppressed T2-weighted imaging, T2 measurement, DTI and sciatic nerve functional assessment were performed at a 3.0 Tesla MR unit over an 8-week follow-up, with histological assessments performed at regular intervals. The sciatic nerve function index, T2 value, and DTI metrics, including fractional anisotropy (FA), axial diffusivity, radial diffusivity (RD), and mean diffusivity values of the distal stumps of crushed nerves were measured and compared between the two groups. RESULTS Nerves treated with MSCs showed better functional recovery and exhibited more pronounced nerve regeneration compared with nerves treated with PBS. T2 values in nerves treated with MSCs or PBS showed a similar change pattern (P = 0.174), while FA and RD values in nerves treated with MSCs showed more rapid return (one week earlier) to baseline level than nerves treated with PBS (P = 0.045; 0.035). Nerves treated with MSCs had higher FA and lower RD values than nerves treated with PBS during the period from 2 to 3 weeks after surgery (P ≤ 0.0001, 0.004; P = 0.004, 0.006). CONCLUSION FA and RD values derived from DTI might be used as sensitive biomarkers for detecting the therapeutic effect of stem cells in acute peripheral nerve crush injuries. LEVEL OF EVIDENCE 2 J. Magn. Reson. Imaging 2017;45:855-862.
Collapse
Affiliation(s)
- Yue-Yao Chen
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Xiang Zhang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Xiao-Feng Lin
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Fang Zhang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Xiao-Hui Duan
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Chu-Shan Zheng
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Mei-Wei Chen
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Dong-Ye Wang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Wei-Ke Zeng
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jun Shen
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| |
Collapse
|
19
|
Boyer RB, Kelm ND, Riley DC, Sexton KW, Pollins AC, Shack RB, Dortch RD, Nanney LB, Does MD, Thayer WP. 4.7-T diffusion tensor imaging of acute traumatic peripheral nerve injury. Neurosurg Focus 2016; 39:E9. [PMID: 26323827 DOI: 10.3171/2015.6.focus1590] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Diagnosis and management of peripheral nerve injury is complicated by the inability to assess microstructural features of injured nerve fibers via clinical examination and electrophysiology. Diffusion tensor imaging (DTI) has been shown to accurately detect nerve injury and regeneration in crush models of peripheral nerve injury, but no prior studies have been conducted on nerve transection, a surgical emergency that can lead to permanent weakness or paralysis. Acute sciatic nerve injuries were performed microsurgically to produce multiple grades of nerve transection in rats that were harvested 1 hour after surgery. High-resolution diffusion tensor images from ex vivo sciatic nerves were obtained using diffusion-weighted spin-echo acquisitions at 4.7 T. Fractional anisotropy was significantly reduced at the injury sites of transected rats compared with sham rats. Additionally, minor eigenvalues and radial diffusivity were profoundly elevated at all injury sites and were negatively correlated to the degree of injury. Diffusion tensor tractography showed discontinuities at all injury sites and significantly reduced continuous tract counts. These findings demonstrate that high-resolution DTI is a promising tool for acute diagnosis and grading of traumatic peripheral nerve injuries.
Collapse
Affiliation(s)
- Richard B Boyer
- Departments of 1 Biomedical Engineering and.,Plastic Surgery, Vanderbilt University Medical Center
| | - Nathaniel D Kelm
- Departments of 1 Biomedical Engineering and.,Vanderbilt University Institute of Imaging Science, Nashville, Tennessee; and
| | | | - Kevin W Sexton
- Plastic Surgery, Vanderbilt University Medical Center;,Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | - R Bruce Shack
- Plastic Surgery, Vanderbilt University Medical Center
| | - Richard D Dortch
- Departments of 1 Biomedical Engineering and.,Vanderbilt University Institute of Imaging Science, Nashville, Tennessee; and
| | | | - Mark D Does
- Departments of 1 Biomedical Engineering and.,Vanderbilt University Institute of Imaging Science, Nashville, Tennessee; and
| | - Wesley P Thayer
- Departments of 1 Biomedical Engineering and.,Plastic Surgery, Vanderbilt University Medical Center
| |
Collapse
|
20
|
Ding WQ, Gu JH, Yuan Y, Jin DS. Stereoscopic Display of the Peripheral Nerves at the Elbow Region Based on MR Diffusion Tensor Imaging with Multiple Post-Processing Methods. IRANIAN JOURNAL OF RADIOLOGY 2016; 13:e22144. [PMID: 27110337 PMCID: PMC4836049 DOI: 10.5812/iranjradiol.22144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 08/23/2014] [Accepted: 08/30/2014] [Indexed: 11/30/2022]
Abstract
Background: Peripheral nerves at the elbow region are prone to entrapment neuropathies and injuries. To make accurate assessment, clinicians need stereoscopic display of the nerves to observe them at all angles. Objectives: To obtain a stereoscopic display of the peripheral nerves at the elbow region based on magnetic resonance (MR) diffusion tensor imaging (DTI) data using three post-processing methods of volume rendering (VR), maximum intensity projection (MIP), and fiber tractography, and to evaluate the difference and correlation between them. Subjects and Methods: Twenty-four elbows of 12 healthy young volunteers were assessed by 20 encoding diffusion direction MR DTI scans. Images belonging to a single direction (anterior-posterior direction, perpendicular to the nerve) were subjected to VR and MIP reconstruction. All raw DTI data were transferred to the Siemens MR workstation for fiber tractography post-processing. Imaging qualities of fiber tractography and VR/MIP were evaluated by two observers independently based on a custom evaluation scale. Results: Stereoscopic displays of the nerves were obtained in all 24 elbows by VR, MIP, and fiber tractography post-processing methods. The VR/MIP post-processing methods were easier to perform compared to fiber tractography. There was no significant difference among the scores of fiber tracking and VR/MIP reconstruction for single direction. The imaging quality scores of fiber tractography and VR/MIP were significantly correlated based on intraclass correlation coefficient (ICC) analysis (ICC ranged 0.709 - 0.901), which suggested that the scores based on fiber tractography and VR/MIP for the same sample were consistent. Inter- and intraobserver agreements were good to excellent. Conclusion: Stereoscopic displays of the peripheral nerves at the elbow region can be achieved by using VR, MIP, and fiber tracking post-processing methods based on raw DTI images. VR and MIP reconstruction could be used as preview tools before fiber tracking to determine whether the raw images are satisfactory.
Collapse
Affiliation(s)
- Wen Quan Ding
- Department of Hand Surgery, Ningbo No.6 Hospital, Ningbo University, Ningbo, China
| | - Jian Hui Gu
- Department of Hand Surgery, Hand Surgery Research Center, Affiliated Hospital of Nantong University, Nantong University, Nantong, China
| | - Yong Yuan
- Department of Radiology, Jiangsu Province Official Hospital, Jiangsu Jiankang Vocational College, Nanjing, China
| | - Dong Sheng Jin
- Department of Radiology, Jiangsu Province Official Hospital, Jiangsu Jiankang Vocational College, Nanjing, China
- Corresponding author: Dong Sheng Jin, Department of Radiology, Jiangsu Province Official Hospital, Jiangsu Jiankang Vocational College, Nanjing, China. Tel: +86-02583712838-3067, Fax: +86-02586631726, E-mail:
| |
Collapse
|
21
|
Kumar Y, Wadhwa V, Phillips L, Pezeshk P, Chhabra A. MR imaging of skeletal muscle signal alterations: Systematic approach to evaluation. Eur J Radiol 2016; 85:922-35. [PMID: 27130052 DOI: 10.1016/j.ejrad.2016.02.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/02/2016] [Accepted: 02/03/2016] [Indexed: 01/24/2023]
Abstract
Muscle edema or edema-like signal alterations are commonly encountered findings in musculoskeletal magnetic resonance (MR) imaging. Although such signal alterations are very sensitive for detection of the underlying muscle pathology, these are often non-specific findings. Encompassing knowledge of their typical clinical presentations, characteristic appearances and patterns of muscle signal alterations and following a systematic approach towards their assessment, a reader can effectively narrow down the differential diagnosis. This article outlines the role of conventional imaging and advanced anatomic and functional musculoskeletal MR imaging techniques in the evaluation of various muscle disorders and presents a systematic approach towards their diagnosis and management.
Collapse
Affiliation(s)
- Yogesh Kumar
- Department of Radiology, Yale New Haven Health System at Bridgeport Hospital, CT, United States
| | - Vibhor Wadhwa
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Lauren Phillips
- Department of Neurology and Neurotherapeutics, UT Southwestern Medical Center, Dallas, TX, United States
| | - Parham Pezeshk
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Avneesh Chhabra
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, United States.
| |
Collapse
|
22
|
Hou ZJ, Huang Y, Fan ZW, Li XC, Cao BY. Changes in lumbosacral spinal nerve roots on diffusion tensor imaging in spinal stenosis. Neural Regen Res 2016; 10:1860-4. [PMID: 26807125 PMCID: PMC4705802 DOI: 10.4103/1673-5374.170317] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Lumbosacral degenerative disc disease is a common cause of lower back and leg pain. Conventional T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI) scans are commonly used to image spinal cord degeneration. However, these modalities are unable to image the entire lumbosacral spinal nerve roots. Thus, in the present study, we assessed the potential of diffusion tensor imaging (DTI) for quantitative assessment of compressed lumbosacral spinal nerve roots. Subjects were 20 young healthy volunteers and 31 patients with lumbosacral stenosis. T2WI showed that the residual dural sac area was less than two-thirds that of the corresponding normal area in patients from L3 to S1 stenosis. On T1WI and T2WI, 74 lumbosacral spinal nerve roots from 31 patients showed compression changes. DTI showed thinning and distortion in 36 lumbosacral spinal nerve roots (49%) and abruption in 17 lumbosacral spinal nerve roots (23%). Moreover, fractional anisotropy values were reduced in the lumbosacral spinal nerve roots of patients with lumbosacral stenosis. These findings suggest that DTI can objectively and quantitatively evaluate the severity of lumbosacral spinal nerve root compression.
Collapse
Affiliation(s)
- Zhong-Jun Hou
- Department of Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Yong Huang
- Department of Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Zi-Wen Fan
- Department of Orthopedics, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Xin-Chun Li
- Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Bing-Yi Cao
- Department of Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| |
Collapse
|
23
|
Wan Q, Wang S, Zhou J, Zou Q, Deng Y, Wang S, Zheng X, Li X. Evaluation of radiation-induced peripheral nerve injury in rabbits with MR neurography using diffusion tensor imaging andT2measurements: Correlation with histological and functional changes. J Magn Reson Imaging 2015; 43:1492-9. [PMID: 26691400 DOI: 10.1002/jmri.25114] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 11/23/2015] [Indexed: 12/22/2022] Open
Affiliation(s)
- Qi Wan
- Department of Radiology; First Affiliated Hospital of Guangzhou Medical University; Guangzhou Guangdong China
| | - Shiyang Wang
- Department of Radiology; Medical Center of University of Chicago; Chicago Illinois USA
| | - Jiaxuan Zhou
- Department of Radiology; First Affiliated Hospital of Guangzhou Medical University; Guangzhou Guangdong China
| | - Qiao Zou
- Department of Radiology; First Affiliated Hospital of Guangzhou Medical University; Guangzhou Guangdong China
| | - Yingshi Deng
- Department of Radiology; First Affiliated Hospital of Guangzhou Medical University; Guangzhou Guangdong China
| | - Shouyang Wang
- Department of Radiology; First Affiliated Hospital of Guangzhou Medical University; Guangzhou Guangdong China
| | | | - Xinchun Li
- Department of Radiology; First Affiliated Hospital of Guangzhou Medical University; Guangzhou Guangdong China
| |
Collapse
|
24
|
|
25
|
In vivo evaluation of rabbit sciatic nerve regeneration with diffusion tensor imaging (DTI): correlations with histology and behavior. Magn Reson Imaging 2015; 33:95-101. [DOI: 10.1016/j.mri.2014.09.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Revised: 08/23/2014] [Accepted: 09/22/2014] [Indexed: 11/21/2022]
|
26
|
In Vivo Evaluation of Sciatic Nerve Crush Injury Using Diffusion Tensor Imaging. J Comput Assist Tomogr 2014; 38:790-6. [DOI: 10.1097/rct.0000000000000118] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|