Whole-Body Neurography

By bmartin on July 30, 2009 10:12 AM |

Visualization of the central nervous system—namely the brain and spinal cord—with MR imaging has been routinely available for about 2 decades. But assessment of the peripheral nerves is largely confined to biopsy data or physiologic measurements (eg, nerve conduction studies and electromyography).* Historically the problem of using common MR methods to inspect long stretches of peripheral nerve has been confounded by similarities in signal intensities between the nerve and its surrounding tissues.

Now investigators in Japan and The Netherlands report their technique of "whole-body MR neurography" to support the diagnosis of chronic inflammatory demyelinating polyneuropathy, or CIDP, an acquired, autoimmune disorder of the peripheral nerves. Their MR method is provided in correspondence within the latest issue of the NEJM.

In short, the technique suppresses background signals from surrounding body tissues to enable detailed views of diseased, thickened nerves. Abnormalities are readily apparent in comparison views of the brachial plexus in a healthy 23-year-old man (A) and that in a 73-year-old man with CIDP (B).

MR_neurography_A.jpgMR_neurography_B.jpg

The practical utility of MR neurography is questionable, however, given that the diagnosis of many peripheral-nerve disorders—and specifically those in which the nerves are not subtly diseased—can be made by using currently available methods. Also the technique would seem to have its limitations in cases of atretic nerve disorders, like advanced axonal neuropathies. But the pictures are way cool.

MR = magnetic resonance.

* Although the condition of very proximal nerve roots is typically assessed with spinal MR imaging.

Detail from Figure 1 in Yamashita T, Kwee TC, Takahara T. Whole-body magnetic resonance neurography. N Engl J Med. 2009;361:538-539.

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This page contains a single entry by bmartin published on July 30, 2009 10:12 AM.

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