Tractography of the Median Nerve

ABSTRACT

The median nerve is one of the most commonly affected peripheral nerves in various pathologies such as entrapment syndromes or transections. The diagnostic procedures applied in these situations are electromyography, physical examination methods, ultrasonography, and magnetic resonance imaging. Diffusion tensor imaging (DTI) has been used mostly in imaging the central nervous system (CNS) to visualize white matter tracts. Several studies have shown the clinical applications of DTI in neuronal disorders such as stroke, epilepsy, and CNS tumors. Recently, peripheral nerves have been visualized with DTI. Also, in several pathologies such as carpal tunnel syndrome and transection of the median nerve, on postoperative follow-up anisotropy indexes were shown to be affected. However, new studies with larger series are needed.

KEYWORDS

Median nerve - peripheral nerve - magnetic resonance imaging - diffusion tensor imaging

REFERENCES

• 1 Andreisek G, Crook D W, Burg D et al.. Peripheral neuropathies of the median, radial, and ulnar nerves: MR imaging features.  Radiographics. 2006;  26(5) 1267-1287
• 2 Sallomi D, Janzen D L, Munk P L et al.. Muscle denervation patterns in upper limb nerve injuries: MR imaging findings and anatomic basis.  AJR Am J Roentgenol. 1998;  171(3) 779-784
• 3 Upper limb. In: Moore KL, Dalley AF Clinically Oriented Anatomy. 5th ed. Baltimore, MD; Lippincott, Williams& Wilkins 2006: 725-884
• 4 Rotman M B, Donovan J B. Practical anatomy of the carpal tunnel.  Hand Clin. 2002;  18 219-230
• 5 Diseases of spinal nerve roots and peripheral nerves. In Mumenthaler M, Mattle H Fundamentals of Neurology: An Illustrated Guide. Stuttgart, Germany; Thieme 2006: 227-231
• 6 Grant G A, Goodkin R, Kliot M. Evaluation and surgical management of peripheral nerve problems.  Neurosurgery. 1999;  44(4) 825-839
• 7 Melhem E R, Mori S, Mukundan G et al.. Diffusion tensor MR imaging of the brain and white matter tractography.  AJR Am J Roentgenol. 2002;  178(1) 3-16
• 8 Westbrook C. MRI at a Glance. Malden, MA; Blackwell Science 2002
• 9 Stieltjes B, Kaufmann W E, van Zijl P C et al.. Diffusion tensor imaging and axonal tracking in the human brainstem.  Neuroimage. 2001;  14 723-735
• 10 Zhang S, Laidlow D H, Kindlmann G. Diffusion tensor MRI visualization. In: Hansen CD, Johnson CR The Visualization Handbook. Oxford, UK; Elsevier 2005: 327-340
• 11 Bammer R. Basic principles of diffusion-weighted imaging.  Eur J Radiol. 2003;  45 169-184
• 12 Basser P J, Pierpaoli C. Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI.  J Magn Reson B. 1996;  111 209-219
• 13 Jellison B J, Field A S, Medow J et al.. Diffusion tensor imaging of cerebral white matter: a pictorial review of physics, fiber tract anatomy, and tumor imaging patterns.  AJNR Am J Neuroradiol. 2004;  25 356-369
• 14 Nucifora P G, Verma R, Lee S K, Melhem E R. Diffusion-tensor MR imaging and tractography: exploring brain microstructure and connectivity.  Radiology. 2007;  245(2) 367-384
• 15 Tsuchiya K, Fujikawa A, Suzuki Y. Diffusion tractography of the cervical spinal cord by using parallel imaging.  AJNR Am J Neuroradiol. 2005;  26(2) 398-400
• 16 Budzik J F, Le Thuc V, Demondion X et al.. In vivo MR tractography of thigh muscles using diffusion imaging: initial results.  Eur Radiol. 2007;  17(12) 3079-3085
• 17 Skorpil M, Karlsson M, Nordell A. Peripheral nerve diffusion tensor imaging.  Magn Reson Imaging. 2004;  22 743-745
• 18 Hiltunen J, Suortti T, Arvela S, Seppa M, Joensuu R, Hari R. Diffusion tensor imaging and tractography of distal peripheral nerves at 3T.  Clin Neurophysiol. 2005;  116 2315-2323
• 19 Meek M F, Stenekes M W, Hoogduin H M, Nicolai J P. In vivo three-dimensional reconstruction of human median nerves by diffusion tensor imaging.  Exp Neurol. 2006;  198 479-482
• 20 Kabakci N, Gürses B, Firat Z et al.. Diffusion tensor imaging and tractography of median nerve: normative diffusion values.  AJR Am J Roentgenol. 2007;  189(4) 923-927
• 21 Khalil C, Hancart C, Le Thuc V et al.. Diffusion tensor imaging and tractography of the median nerve in carpal tunnel syndrome: preliminary results.  Eur Radiol. 2008;  18(10) 2283-2291
• 22 Bendszus M, Stoll G. Technology insight: visualizing peripheral nerve injury using MRI.  Nat Clin Pract Neurol. 2005;  1 45-53
• 23 Seddon H J. Three types of nerve injury.  Brain. 1943;  66 237-288
• 24 Mackinnon S E. Pathophysiology of nerve compression.  Hand Clin. 2002;  18 231-241
• 25 Buchthal F, Rosenfalck A, Trojaborg W. Electrophysiological findings in entrapment of the median nerve at wrist and elbow.  J Neurol Neurosurg Psychiatry. 1974;  37(3) 340-360
• 26 Sunderland S. The nerve lesion in the carpal tunnel syndrome.  J Neurol Neurosurg Psychiatry. 1976;  39(7) 615-626
• 27 Thomas P K, Fullerton P M. Nerve fibre size in the carpal tunnel syndrome.  J Neurol Neurosurg Psychiatry. 1963;  26 520-527
• 28 Clippinger F W, Goldner J L, Roberts J M. Use of electromyogram in evaluating upper-extremity peripheral nerve lesions.  J Bone Joint Surg [Am]. 1962;  44A 1047-1060
• 29 Le Bihan D, van Zijl P. From the diffusion coefficient to the diffusion tensor.  NMR Biomed. 2002;  15 431-434
• 30 Raybaud C, Shroff M, Rutka J T, Chuang S H. Imaging surgical epilepsy in children.  Childs Nerv Syst. 2006;  22 786-809
• 31 Inoue T, Ogasawara K, Beppu T, Ogawa A, Kabasawa H. Diffusion tensor imaging for preoperative evaluation of tumor grade in gliomas.  Clin Neurol Neurosurg. 2005;  107 174-180
• 32 Thomalla G, Glauche V, Weiller C. Time course of wallerian degeneration after ischaemic stroke revealed by diffusion tensor imaging.  J Neurol Neurosurg Psychiatry. 2005;  76(2) 266-268
• 33 Thomalla G, Glauche V, Koch M A et al.. Diffusion tensor imaging detects early Wallerian degeneration of the pyramidal tract after ischemic stroke.  Neuroimage. 2004;  22(4) 1767-1774
• 34 Stanisz G J, Midha R, Munro C A et al.. MR properties of rat sciatic nerve following trauma.  Magn Reson Med. 2001;  45(3) 415-420
• 35 Beaulieu C, Does M D, Snyder R E et al.. Changes in water diffusion due to Wallerian degeneration in peripheral nerve.  Magn Reson Med. 1996;  36(4) 627-631