Diffusion-weighted MR neurography of median and ulnar nerves in the wrist and palm
Diffusion-weighted MR neurography of median and ulnar nerves in the wrist and palm
复制标题
手腕和手掌正中神经和尺神经的弥散加权 MR 神经成像
DOI：
10.1007/s00330-016-4591-0
复制
发表时间：
2017-06-01
影响因子：
5.9
通讯作者：
Chhabra, Avneesh
中科院分区：
文献类型：
--
作者：
Bao, Hongjing;Wang, Shanshan;Chhabra, Avneesh
ObjectivesTo探讨扩散加权磁共振神经成像（DW-MRN）在腕部和手掌的四肢神经的可视化的可行性。MethodsThirteen志愿者和21例患者进行了手腕和手掌的成像3-T MR扫描仪。两名放射科医师使用四点分级量表对所有受试者的DW-MRN图像质量进行评价。获得观察者间性能的Kappa统计量。在志愿者中，卡方检验用于评估DW-MRN和轴向脂肪抑制质子密度加权成像（FS-PDWI）上神经可视化的差异。结果在志愿者中，观察者1的正中神经（MN）和尺神经（UN）的平均图像质量评分分别为3.71 ± 0.46和3.23 ± 0.67，观察者2分别为3.70 ± 0.46和3.22 ± 0.71。观察者间一致性分别为极好（k = 0.843）和良好（k = 0.788）。DW-MRN对第二、三指掌侧总神经及尺神经三支的显示较FS-PDWI明显改善（P< 0.05）。在患者中，两名观察者的平均图像质量评分分别为3.24 ± 0.62和3.10 ± 0.83，观察者间表现极佳（k = 0.842）.结论DW-MRN在改善腕部和手掌部肢体神经及其病变的显示方面是可行的，并具有足够的图像质量，关键点·DW-MRN为腕部和手掌神经造影提供了足够的图像质量·DW-MRN在腕部神经可视化方面与FS-PDWI相似·DW-MRN可改善手掌小神经的可视化。DW-MRN可作为评估周围神经病变的补充方法
ObjectivesTo investigate the feasibility of diffusion-weighted magnetic resonance neurography (DW-MRN) in the visualisation of extremity nerves in the wrist and palm.MethodsThirty-two volunteers and 21 patients underwent imaging of the wrist and palm on a 3-T MR scanner. In all subjects, two radiologists evaluated the image quality on DW-MRN using a four-point grading scale. Kappa statistics were obtained for inter-observer performance. In volunteers, the chi-squared test was used to assess the differences in nerve visualisation on DW-MRN and axial fat-suppressed proton density weighted imaging (FS-PDWI).ResultsIn volunteers, the mean image quality scores for the median nerve (MN) and ulnar nerve (UN) were 3.71 ± 0.46 and 3.23 ± 0.67 for observer 1, and 3.70 ± 0.46 and 3.22 ± 0.71 for observer 2, respectively. The inter-observer agreement was excellent (k = 0.843) and good (k = 0.788), respectively. DW-MRN provided significantly improved visualisations of the second and the third common palmar digital nerves and three branches of UN compared with FS-PDWI (P< 0.05). In patients, the mean image quality scores for the two observers were 3.24 ± 0.62 and 3.10 ± 0.83, inter-observer performance was excellent (k = 0.842).ConclusionsDW-MRN is feasible for improved visualisation of extremity nerves and their lesions in the wrist and palm with adequate image quality, thereby providing a supplementary method to conventional MR imaging.Key points•DW-MRN provides adequate image quality for wrist and palm neurography•DW-MRN performs similarly to FS-PDWI in nerve visualisation at the wrist•DW-MRN provides improved visualisation of small nerves in the palm•DW-MRN serves as a supplementary method to evaluate peripheral neuropathies