Läsionen peripherer Nerven: MR-Neurografie als innovative Ergänzung zur Elektrodiagnostik

Zusammenfassung

Die Diagnostik peripherer Nervenschädigungen beruht bislang vor allem auf neurophysiologischen Untersuchungsverfahren. Technische Fortschritte im Bereich der Magnetresonanztomografie (MRT) ermöglichen zunehmend, die Magnetresonanz (MR)-Neurografie auch in der Abklärung von Erkrankungen des peripheren Nervensystems einzusetzen. Anhand experimenteller Untersuchungen wird dargestellt, wie die MR-Neurografie axonale und entmarkende Läsionen peripherer Nerven sichtbar machen kann. Im klinischen Einsatz kann die MR-Neurografie in Kombination mit neurophysiologischen Verfahren die Diagnosefindung bei fokalen Nervenläsionen im Rahmen von Engpass-Syndromen, traumatischen oder anderen Läsionen verbessern. Sie leistet insbesondere einen wertvollen Beitrag zur exakten Lokalisationsdiagnostik in Körperregionen, die der Elektrodiagnostik schwer zugänglich sind. Aber auch bei Polyneuropathien können durch die MR-Neurografie neue pathophysiologische Erkenntnisse gewonnen werden, wie anhand der diabetischen Neuropathie erläutert wird.

Abstract

The diagnostic work-up of peripheral neuropathies largely depends on neurophysiological investigations. Recently, progress in magnetic resonance imaging (MRI) has lead to new perspectives in the diagnostics of disorders of the peripheral nervous system (PNS). Experimental data show how MR neurography visualises axonal and demyelinating lesions of the PNS. In clinical use, difficult cases of focal nerve compres­sion, traumatic or inflammatory lesions can be solved by the combination of MR neurography and neurophysiology. In particular, the localisation of nerve lesions can be improved by MR techniques. Furthermore, MR neurography enables new insights in the pathophysiology of neuropathies which will be shown for diabetic polyneuropathy.

Schlüsselwörter

Magnetresonanz-Neurografie - klinische Neurophysiologie - peripheren Nervensystem - axonale Läsionen - Demyelination

Key words

magnetic resonance neurography - clinical neurophysiology - peripheral nervous system - axonal lesion - demyelination

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