Tim Godel1, Mirko Pham2, Sabine Heiland3, Martin Bendszus4, Philipp Bäumer5. 1. Department of Neuroradiology, Neurological University Clinic, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. Electronic address: Tim.godel@med.uni-heidelberg.de. 2. Department of Neuroradiology, Neurological University Clinic, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. Electronic address: Mirko.pham@med.uni-heidelberg.de. 3. Department of Neuroradiology, Neurological University Clinic, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. Electronic address: Sabine.heiland@med.uni-heidelberg.de. 4. Department of Neuroradiology, Neurological University Clinic, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. Electronic address: Martin.bendszus@med.uni-heidelberg.de. 5. Department of Neuroradiology, Neurological University Clinic, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; Department of Radiology, German Cancer Research Institute, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany. Electronic address: P.baeumer@dkfz-heidelberg.de.
Abstract
PURPOSE: To develop an in-vivo imaging method for the measurement of dorsal-root-ganglia-(DRG) perfusion, to establish its normal values in patients without known peripheral nerve disorders or radicular pain syndromes and to determine the physiological spatial perfusion pattern within the DRG. METHODS: This prospective study was approved by the institutional ethics committee and written informed consent was obtained from all participants. 46 (24 female, 22 male, mean age 46.0±15.2years) subjects without known peripheral neuropathies or pain syndromes were examined by a 3Tesla MRI scanner (Magnetom VERIO or TRIO, Siemens AG, Erlangen, Germany) with a VIBE (Volume-Interpolated-Breathhold-Examination) dynamic-contrast-enhanced (DCE) T1-w-sequence (TR/TE 3.3/1.11ms; 24 slices; voxel resolution 1.3×1.3×3.0mm(3)) covered the pelvis from the upper plate of the 5th lumbar vertebra to the 2nd sacral vertebra. Transfer-constant (K(trans)) and interstitial-volume-fraction (interstitial-leakage-fraction, Ve) were modeled for the DRG and spinal nerve by applying the Tofts-model. Statistical analyses included pairwise comparisons of L5/S1 DRG vs. spinal nerve. Furthermore, distinct physiological zones within the S1 DRG were compared (cell body rich area (CBRA) vs. nerve fiber rich area (NFRA)). RESULTS: DRG showed a significantly increased permeability compared to spinal nerve (K(trans) 3.8±1.5 10(-3)/min vs. 1.6±0.9 10(-3)/min, p-value: <0.001) combined with an increased interstitial leakage of contrast agent into the extravascular-extracellular-space (Ve 38.1±19.2% vs. 17.3±9.9%, p-value: <0.001). Parameters showed no statistically significant difference on DRG-level (L5 vs. S1; p-value: 0.62 (K(trans)); 0.17 (Ve)) and -side (left vs. right; p-value: 0.25 (K(trans)); 0.79 (Ve)). Female gender was associated with a significantly increased permeability (K(trans) female 4.3±1.4 10(-3)/min vs. male 3.4±0.9 10(-3)/min, p-value: <0.05) but no statistically significant differences in interstitial leakage (Ve female 40.1±14,1% vs. male 34.5±17.4%, p-value: 0.24). DRG showed distinct spatial distribution patterns of perfusion: K(trans) and Ve were significantly higher in the CBRA than in the NFRA (K(trans) 4.4±1.8 10(-3)/min vs. 1.7±1.2 10(-3)/min, p-value: <0.001 and Ve 40.9±21.3% vs. 15.1±11.7%, p-value: <0.001). CONCLUSION: Non-invasive and in-vivo measurement of human DRG perfusion by MRI is a feasible technique. DRG show substantially higher permeability and interstitial leakage than spinal nerves. Even distinct physiological perfusion patterns for different microstructural compartments could be observed within the DRG. The technique may become particularly useful for future research on the poorly understood human sensory neuropathies and pain syndromes.
PURPOSE: To develop an in-vivo imaging method for the measurement of dorsal-root-ganglia-(DRG) perfusion, to establish its normal values in patients without known peripheral nerve disorders or radicular pain syndromes and to determine the physiological spatial perfusion pattern within the DRG. METHODS: This prospective study was approved by the institutional ethics committee and written informed consent was obtained from all participants. 46 (24 female, 22 male, mean age 46.0±15.2years) subjects without known peripheral neuropathies or pain syndromes were examined by a 3Tesla MRI scanner (Magnetom VERIO or TRIO, Siemens AG, Erlangen, Germany) with a VIBE (Volume-Interpolated-Breathhold-Examination) dynamic-contrast-enhanced (DCE) T1-w-sequence (TR/TE 3.3/1.11ms; 24 slices; voxel resolution 1.3×1.3×3.0mm(3)) covered the pelvis from the upper plate of the 5th lumbar vertebra to the 2nd sacral vertebra. Transfer-constant (K(trans)) and interstitial-volume-fraction (interstitial-leakage-fraction, Ve) were modeled for the DRG and spinal nerve by applying the Tofts-model. Statistical analyses included pairwise comparisons of L5/S1 DRG vs. spinal nerve. Furthermore, distinct physiological zones within the S1 DRG were compared (cell body rich area (CBRA) vs. nerve fiber rich area (NFRA)). RESULTS: DRG showed a significantly increased permeability compared to spinal nerve (K(trans) 3.8±1.5 10(-3)/min vs. 1.6±0.9 10(-3)/min, p-value: <0.001) combined with an increased interstitial leakage of contrast agent into the extravascular-extracellular-space (Ve 38.1±19.2% vs. 17.3±9.9%, p-value: <0.001). Parameters showed no statistically significant difference on DRG-level (L5 vs. S1; p-value: 0.62 (K(trans)); 0.17 (Ve)) and -side (left vs. right; p-value: 0.25 (K(trans)); 0.79 (Ve)). Female gender was associated with a significantly increased permeability (K(trans) female 4.3±1.4 10(-3)/min vs. male 3.4±0.9 10(-3)/min, p-value: <0.05) but no statistically significant differences in interstitial leakage (Ve female 40.1±14,1% vs. male 34.5±17.4%, p-value: 0.24). DRG showed distinct spatial distribution patterns of perfusion: K(trans) and Ve were significantly higher in the CBRA than in the NFRA (K(trans) 4.4±1.8 10(-3)/min vs. 1.7±1.2 10(-3)/min, p-value: <0.001 and Ve 40.9±21.3% vs. 15.1±11.7%, p-value: <0.001). CONCLUSION: Non-invasive and in-vivo measurement of human DRG perfusion by MRI is a feasible technique. DRG show substantially higher permeability and interstitial leakage than spinal nerves. Even distinct physiological perfusion patterns for different microstructural compartments could be observed within the DRG. The technique may become particularly useful for future research on the poorly understood humansensory neuropathies and pain syndromes.
Authors: Tim Godel; Anja Köhn; Nicole Muschol; Moritz Kronlage; Daniel Schwarz; Jennifer Kollmer; Sabine Heiland; Martin Bendszus; Victor-Felix Mautner; Philipp Bäumer Journal: J Neurol Date: 2018-09-12 Impact factor: 4.849
Authors: Barbara Hofstadler; Philipp Bäumer; Daniel Schwarz; Moritz Kronlage; Sabine Heiland; Martin Bendszus; Tim Godel Journal: Clin Neuroradiol Date: 2019-09-05 Impact factor: 3.649
Authors: Leonidas Apostolidis; Lars Kowalscheck; Tim Frederik Weber; Tim Godel; Martin Bendszus; Hans-Ulrich Kauczor; Dirk Jäger; Heinz-Peter Schlemmer; Philipp Bäumer Journal: Clin Neuroradiol Date: 2021-09-09 Impact factor: 3.156
Authors: Leonidas Apostolidis; Daniel Schwarz; Annie Xia; Markus Weiler; Andreas Heckel; Tim Godel; Sabine Heiland; Heinz-Peter Schlemmer; Dirk Jäger; Martin Bendszus; Philipp Bäumer Journal: PLoS One Date: 2017-08-24 Impact factor: 3.240
Authors: Elia R Lopez; Anibal Garza Carbajal; Jin Bin Tian; Alexis Bavencoffe; Michael X Zhu; Carmen W Dessauer; Edgar T Walters Journal: Neuropharmacology Date: 2020-11-18 Impact factor: 5.250
Authors: Juliette Hordeaux; Christian Hinderer; Tamara Goode; Elizabeth L Buza; Peter Bell; Roberto Calcedo; Laura K Richman; James M Wilson Journal: Mol Ther Methods Clin Dev Date: 2018-07-14 Impact factor: 6.698
Authors: Juliette Hordeaux; Christian Hinderer; Tamara Goode; Nathan Katz; Elizabeth L Buza; Peter Bell; Roberto Calcedo; Laura K Richman; James M Wilson Journal: Mol Ther Methods Clin Dev Date: 2018-07-14 Impact factor: 6.698