MR neurography and muscle MR imaging for image diagnosis of disorders affecting the peripheral nerves and musculature
MR neurography and muscle MR imaging for image diagnosis of disorders affecting the peripheral nerves and musculature
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DOI：
10.1016/j.ncl.2004.03.005
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发表时间：
2004-08-01
影响因子：
2.4
通讯作者：
Tsuruda, JS
中科院分区：
文献类型：
--
作者：
Filler, AG;Maravilla, KR;Tsuruda, JS
医学成像，包括MR成像[1]，在诊断影响周围神经和肌肉的疾病方面发挥着越来越重要的作用[2，3]。在过去，神经MR成像的实际应用受到获得良好图像对比度以帮助区分神经与邻近组织的技术困难的限制[4-9]。相比之下，超声[10]用于神经识别的有限能力似乎是有用的。然而，最近，磁共振成像技术的进步和增强已经改变了过去提出的诊断挑战的各种条件的评价，术语MR神经成像被用来描述神经成像的新技术，大大提高了识别图像中的周围神经的可靠性，并且通常可以生成类似于血管造影的神经组织特异性图像。这些图像使医生能够检查周围神经的解剖异常。从1992年开始，基础MR科学的一系列发现导致MR神经造影术作为一个独特的成像领域[11，12]。目前该技术已应用于数千例临床病例，一系列出版物涵盖了该技术的基础科学[13-15]、成像科学[16，17]和临床应用[18-23]。大型、对照良好的正式结果试验[24，25]已经证实，至少在某些情况下，MR神经成像在定位周围神经疾病和指导治疗计划方面比电诊断研究更可靠。许多放射科医生在神经成像方面的经验有限，许多成像中心没有足够的装备来成功地进行这些研究。重要的是，转诊医生要清楚地了解如何显示有用的高质量神经图像。神经成像过程的一些一般技术方面的意识可以帮助转诊医生理解和解决在社区引入这种新技术时可能出现的图像平等问题。
Medical imaging, including MR imaging [1], is playing an increasingly important role in the diagnosis of disorders affecting the peripheral nerves and muscles [2,3]. In the past, the practical application of MR imaging of nerves has been limited by technical difficulties in obtaining good image contrast to help distinguish nerve from neighboring tissues [4-9]. By comparison, the limited capabilities of ultrasound [10] for nerve identification have seemed useful. Recently, however, advances and enhancements of MR imaging techniques have transformed the evaluation of a variety of conditions that have posed diagnostic challenges in the past.The term MR neurography is used to describe the new techniques for nerve imaging that greatly improve the reliability of identification of peripheral nerves in images and often make it possible to generate tissue-specific images of nerves analogous to angiograms. These images enable the physician to examine the peripheral nerve for anatomic abnormalities. A series of discoveries in basic MR science beginning in 1992 has led to the establishment of MR neurography as a distinct area of imaging [11,12]. The technique has now been applied in thousands of clinical cases.A series of publications cover the basic science [13-15], imaging science [16,17], and clinical application [18-23] of the technique. Large, well-controlled formal outcome trials [24,25] have established, at least in some settings, that MR neurography can be more reliable than electrodiagnostic studies in localizing peripheral nerve disorders and in guiding treatment planning.The referring physician should be aware of some of the technical aspects of MR nerve imaging. Many radiologists have limited experience with nerve imaging, and many imaging centers are not adequately equipped to carry out these studies successfully. It is important for the referring physician to have a clear idea of how a useful high-quality nerve image should appear. Awareness of some of the general technical aspects of the nerve imaging process can help the referring physician understand and address imagequality problems that can arise as this new technique is introduced in a community.