Moritz Kronlage1, Véronique Schwehr2, Daniel Schwarz2, Tim Godel2, Inga Harting2, Sabine Heiland2, Martin Bendszus2, Philipp Bäumer2,3. 1. Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. moritz.kronlage@med.uni-heidelberg.de. 2. Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. 3. Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
Abstract
OBJECTIVE: Detection and pattern analysis of fascicular nerve hyperintensities in the T2-weighted image are the backbone of magnetic resonance neurography (MRN) as they may represent lesions of various etiologies. The aim of this study was to assess the prevalence of fascicular nerve hyperintensities in healthy individuals with regard to a potential association with age or cerebral white matter lesions. METHODS: Sixty volunteers without peripheral nerve diseases between the age of 20 and 80 underwent MRN (high-resolution T2-weighted) of upper (median, ulnar, radial) and lower (sciatic, tibial) extremity nerves and a fluid-attenuated inversion recovery (FLAIR) sequence of the brain. Presence of peripheral nerve hyperintensities and degree of cerebral white matter lesions were independently rated by two blinded readers and related to each other and to age. T test with Welch's correction was used for group comparisons. Spearman's correlation coefficients were reported for correlation analyses. RESULTS: MR neurography revealed fascicular hyperintensities in 10 of 60 subjects (16.7%). Most frequently, they occurred in the sciatic nerve (8/60 subjects, 13.3%), less frequently in the tibial nerve at the lower leg and the median, ulnar, and radial nerves at the upper arm (1.7-5.0%). Mean age of subjects with nerve hyperintensities was higher than that of those without (60.6 years vs. 48.0 years, p = 0.038). There was only a weak correlation of nerve lesions with age and with cerebral white matter lesions, respectively. CONCLUSION: Fascicular nerve hyperintensities may occur in healthy individuals and should therefore always be regarded in conjunction with the clinical context. KEY POINTS: • MR neurography may reveal fascicular hyperintensities in peripheral nerves of healthy individuals. Fascicular hyperintensities occur predominantly in the sciatic nerve and older individuals. • Therefore, fascicular hyperintensities should only be interpreted as clearly pathologic in conjunction with the clinical context.
OBJECTIVE: Detection and pattern analysis of fascicular nerve hyperintensities in the T2-weighted image are the backbone of magnetic resonance neurography (MRN) as they may represent lesions of various etiologies. The aim of this study was to assess the prevalence of fascicular nerve hyperintensities in healthy individuals with regard to a potential association with age or cerebral white matter lesions. METHODS: Sixty volunteers without peripheral nerve diseases between the age of 20 and 80 underwent MRN (high-resolution T2-weighted) of upper (median, ulnar, radial) and lower (sciatic, tibial) extremity nerves and a fluid-attenuated inversion recovery (FLAIR) sequence of the brain. Presence of peripheral nerve hyperintensities and degree of cerebral white matter lesions were independently rated by two blinded readers and related to each other and to age. T test with Welch's correction was used for group comparisons. Spearman's correlation coefficients were reported for correlation analyses. RESULTS: MR neurography revealed fascicular hyperintensities in 10 of 60 subjects (16.7%). Most frequently, they occurred in the sciatic nerve (8/60 subjects, 13.3%), less frequently in the tibial nerve at the lower leg and the median, ulnar, and radial nerves at the upper arm (1.7-5.0%). Mean age of subjects with nerve hyperintensities was higher than that of those without (60.6 years vs. 48.0 years, p = 0.038). There was only a weak correlation of nerve lesions with age and with cerebral white matter lesions, respectively. CONCLUSION:Fascicular nerve hyperintensities may occur in healthy individuals and should therefore always be regarded in conjunction with the clinical context. KEY POINTS: • MR neurography may reveal fascicular hyperintensities in peripheral nerves of healthy individuals. Fascicular hyperintensities occur predominantly in the sciatic nerve and older individuals. • Therefore, fascicular hyperintensities should only be interpreted as clearly pathologic in conjunction with the clinical context.
Entities:
Keywords:
Healthy volunteers; Magnetic resonance imaging; Peripheral nerves
Authors: Karyn E Chappell; Matthew D Robson; Amanda Stonebridge-Foster; Alan Glover; Joanna M Allsop; Andreanna D Williams; Amy H Herlihy; Jill Moss; Philip Gishen; Graeme M Bydder Journal: AJNR Am J Neuroradiol Date: 2004-03 Impact factor: 3.825
Authors: Julia B Breitenseher; Gottfried Kranz; Alina Hold; Dominik Berzaczy; Stefan F Nemec; Thomas Sycha; Michael Weber; Daniela Prayer; Gregor Kasprian Journal: Eur Radiol Date: 2015-02-14 Impact factor: 5.315
Authors: Moritz Kronlage; Kalliopi Pitarokoili; Daniel Schwarz; Tim Godel; Sabine Heiland; Min-Suk Yoon; Martin Bendszus; Philipp Bäumer Journal: Invest Radiol Date: 2017-11 Impact factor: 6.016
Authors: D S Titelbaum; J L Frazier; R I Grossman; P M Joseph; L T Yu; E A Kassab; W F Hickey; D LaRossa; M J Brown Journal: AJNR Am J Neuroradiol Date: 1989 Jul-Aug Impact factor: 3.825
Authors: Jennifer Kollmer; Ernst Hund; Benjamin Hornung; Ute Hegenbart; Stefan O Schönland; Christoph Kimmich; Arnt V Kristen; Jan Purrucker; Christoph Röcken; Sabine Heiland; Martin Bendszus; Mirko Pham Journal: Brain Date: 2014-12-18 Impact factor: 13.501
Authors: Sven Haller; Enikö Kövari; François R Herrmann; Victor Cuvinciuc; Ann-Marie Tomm; Gilbert B Zulian; Karl-Olof Lovblad; Panteleimon Giannakopoulos; Constantin Bouras Journal: Acta Neuropathol Commun Date: 2013-05-09 Impact factor: 7.801