Die Untersuchung peripherer Nerven mit bildgebenden Methoden

A. Peinemann; A. Berthele

doi:10.1055/s-0038-1626787

Nervenheilkunde, Table of Contents

Nervenheilkunde 2006; 25(10): 831-837
DOI: 10.1055/s-0038-1626787

Originaler Artikel

Schattauer GmbH

Die Untersuchung peripherer Nerven mit bildgebenden Methoden

Examination of peripheral nerves with imaging techniques

A. Peinemann

¹Neurologische Klinik und Poliklinik der Technischen Universität München, Klinikum rechts der Isar (Direktor: Prof. Dr. B. Conrad)

,

A. Berthele

¹Neurologische Klinik und Poliklinik der Technischen Universität München, Klinikum rechts der Isar (Direktor: Prof. Dr. B. Conrad)

› Author Affiliations

Abstract

Zusammenfassung

Die Methoden der Elektrophysiologie gelten unbestritten als der Goldstandard in der Diagnostik von Erkrankungen des peripheren Nervensystems, da sie die Funktion der untersuchten Nerven direkt abbilden. Elektrophysiologische Techniken erlauben jedoch keine Aussagen zu morphologischen Veränderungen und geben damit nur selten Hinweise auf die letztlich zu Grunde liegende Ursache der Erkrankung. Insofern ist durch die ergänzende Anwendung von bildgebenden Methoden ein echter diagnostischer Fortschritt zu erwarten. Die Möglichkeiten der Kernspintomographie, mit den bereits heute zur Verfügung stehenden Sequenzen und konventionellen Untersuchungstechniken zur Diagnostik von Nervenschädigungen beizutragen, werden in diesem Artikel ebenso zusammengefasst wie neue Entwicklungen im Bereich der Sonographie peripherer Nerven.

Summary

Serving asa direct measure of function, electrophysiological techniques are still the mainstay in the diagnostic workup of diseases of the peripheral nerve system. However, and by nature, electrophysiological studies give no idea of the nerve’s morphology, and with respect to the underlying pathology these techniques are for the most part unrewarding. Thus, imaging techniques, applied to the investigation of peripheral nerves, would add most valuable information. The potential of MRI, utilizing conventional sequences, as well as recent developments in ultrasound techniques are reviewed in this article.

Schlüsselwörter

Kernspintomographie - MR-Neurographie - Nerven-Sonographie - Ultraschall - periphere Nerven

Keywords

Magnetic resonance imaging - MR-neurography - sonography - ultrasound - peripheral nerves

Full Text

References

Literatur
1 Howe FA, Filler AG, Bell BA, Griffiths JR. Magnetic resonance neurography. Magn Reson Med 1992; 28: 328-38.
2 Filler AG, Howe FA, Hayes CE, Kliot M, Winn HR, Bell BA, Griffiths JR, Tsuruda JS. Magnetic resonance neurography. Lancet 1993; 341: 659-61.
3 Grant GA, Britz GW, Goodkin R, Jarvik JG, Maravilla KR, Kliot M. The utility of magnetic resonance imaging in evaluating peripheral nerve disorders. Muscle Nerve 2002; 25: 314-31.
4 Grant GA, Goodkin R, Maravilla KR, Kliot M. MR neurography: diagnostic utility in the surgical treatment of peripheral nerve disorders. Neuroimaging Clin N Am 2004; 14: 115-33.
5 Filler AG, Kliot M, Howe FA, Hayes CE. et al. Application of magnetic resonance neurography in the evaluation of patients with peripheral nerve pathology. J Neurosurg 1996; 85: 299-309.
6 Filler AG, Maravilla KR, Tsuruda JS. MR neurography and muscle MR imaging for image diagnosis of disorders affecting the peripheral nerves and musculature. Neurol Clin 2004; 22: 643-82.
7 Cudlip SA, Howe FA, Clifton A, Schwartz MS, Bell BA. Magnetic resonance neurography studies of the median nerve before and after carpal tunnel decompression. J Neurosurg 2002; 96: 1046-51.
8 Uchiyama S, Itsubo T, Yasutomi T, Nakagawa H, Kamimura M, Kato H. Quantitative MRI of the wrist and nerve conduction studies in patients with idiopathic carpal tunnel syndrome. J Neurol Neurosurg Psychiatry 2005; 76: 1103-8.
9 Jarvik JG, Yuen E, Haynor DR, Bradley CM. et al. MR nerve imaging in a prospective cohort of patients with suspected carpal tunnel syndrome. Neurology 2002; 58: 1597-602.
10 Britz GW, Haynor DR, Kuntz C, Goodkin R, Gitter A, Kliot M. Carpal tunnel syndrome: correlation of magnetic resonance imaging, clinical, electrodiagnostic, and intraoperative findings. Neurosurgery 1995; 37: 1097-103.
11 Britz GW, Haynor DR, Kuntz C, Goodkin R. et al. Ulnar nerve entrapment at the elbow: correlation of magnetic resonance imaging, clinical, electrodiagnostic, and intraoperative findings. Neurosurgery 1996; 38: 458-65.
12 Kijowski R, Tuite M, Sanford M. Magnetic resonance imaging of the elbow. Part II: abnormalities of the ligaments, tendons, and nerves. Skeletal Radiol 2005; 34: 1-18.
13 Saifuddin A. Imaging tumours of the brachial plexus. Skeletal Radiol 2003; 32: 375-87.
14 Sarikaya S, Sumer M, Ozdolap S, Erdem CZ. Magnetic resonance neurography diagnosed brachial plexitis: a case report. Arch Phys Med Rehabil 2005; 86: 1058-9.
15 Zhou L, Yousem DM, Chaudhry V. Role of magnetic resonance neurography in brachial plexus lesions. Muscle Nerve 2004; 30: 305-9.
16 Baehring JM, Damek D, Martin EC, Betensky RA, Hochberg FH. Neurolymphomatosis. NeuroOncology 2003; 05: 104-15.
17 Hersekli MA, Akpinar S, Demirors H, Ozkoc G. et al. Synovial cysts of proximal tibiofibular joint causing peroneal nerve palsy: report of three cases and review of the literature. Arch Orthop Trauma Surg 2004; 124: 711-4.
18 McCarthy CL, McNally EG. The MRI appearance of cystic lesions around the knee. Skeletal Radiol 2004; 33: 187-209.
19 Trattnig S, Breitenseher M, Haller J, Helbich T, Gabler C, Imhof H. Tarsaltunnel-Syndrom: MRDiagnostik. Radiologe 1995; 35: 468-72.
20 Zanetti M, Weishaupt D. MR imaging of the forefoot: Morton neuroma and differential diagnoses. Semin Musculoskelet Radiol 2005; 09: 175-86.
21 Filler AG, Haynes J, Jordan SE, Prager J. et al. Sciatica of nondisc origin and piriformis syndrome: diagnosis by magnetic resonance neurography and interventional magnetic resonance imaging with outcome study of resulting treatment. J Neurosurg Spine 2005; 02: 99-115.
22 Simmons Z, Mahadeen ZI, Kothari MJ, Powers S, Wise S, Towfighi J. Localized hypertrophic neuropathy: magnetic resonance imaging findings and long-term follow-up. Muscle Nerve 1999; 22: 28-36.
23 Pilavaki M, Chourmouzi D, Kiziridou A, Skodalaki A, Zarampoukas T, Drevelengas A. Imaging of peripheral nerve sheath tumors with pathologic correlation: pictorial review. Eur J Radiol 2004; 52: 229-39.
24 Cellerini M, Salti S, Desideri V, Marconi G. MR imaging of the cauda equina in hereditary motor sensory neuropathies: correlations with sural nerve biopsy. AJNR Am J Neuroradiol 2000; 21: 1793-8.
25 Ellegala DB, Monteith SJ, Haynor D, Bird TD, Goodkin R, Kliot M. Characterization of genetically defined types of Charcot-Marie-Tooth neuropathies by using magnetic resonance neurography. J Neurosurg 2005; 102: 242-5.
26 Schady W, Goulding PJ, Lecky BRF, King RHM, Smith CML. Massive nerve root enlargement in chronic inflammatory demyelinating polyneuropathy. J Neurol Neurosurg Psychiatry 1996; 61: 636-40.
27 Eurelings M, Notermans NC, Franssen H, van Es HW. et al. MRI of the brachial plexus in polyneuropathy assiciated with monoclonal gammopathy. Muscle Nerve 2001; 24: 1312-8.
28 Bendszus M, Wessig C, Solymosi L, Reiners K, Koltzenburg M. MRI of peripheral nerve degeneration and regeneration: correlation with electrophysiology and histology. Exp Neurol 2004; 188: 171-7.
29 Dailey AT, Tsuruda JS, Filler AG, Maravilla KR, Goodkin R, Kliot M. Magnetic resonance neurography of peripheral nerve degeneration and regeneration. Lancet 1997; 350: 1221-2.
30 Fahr LM, Sauser DD. Imaging of peripheral nerve lesions. Orthop Clin North Am 1988; 19: 27-41.
31 Kele H. Untersuchung der Nerven. In: Reimers CD, Gaulrapp H, Kele H. (Hrsg.) Sonographie der Muskeln, Sehnen und Nerven. 2. Auflage. Köln: Deutscher Ärzteverlag; 2004: 223-83.
32 Bacigalupo L, Bianchi S, Valle M, Martinoli C. Ultraschall peripherer Nerven. Radiologe 2003; 43: 841-9.
33 Peer S, Kovacs P, Harpf C, Bodner G. High-resolution sonography of lower extremity peripheral nerves. J Ultrasound Med 2002; 21: 315-22.
34 Silvestri E, Martinoli C, Derchi LE, Bertolotto M, Chiaramondia M, Rosenberg I. Echotexture of peripheral nerves: correlation between US and histologic findings and criteria to differentiate tendons. Radiology 1995; 197: 291-6.
35 Bianchi S, Montet X, Martinoli C, Bonvin F, Fasel JHD. High-resolution sonography of compressive neuropathies of the wrist. J Clin Ultrasound 2004; 32: 451-61.
36 Kele H, Verheggen R, Bittermann H-J, Reimers CD. The potential value of ultrasonography in the evaluation of carpal tunnel syndrome. Neurology 2003; 61: 389-91.
37 Nakamichi K-I, Tachibana S. Ultrasonographic measurement of median nerve cross-sectional area in idiopathic carpal tunnel syndrome: diagnostic accuracy. Muscle Nerve 2002; 26: 798-803.
38 Beekman R, Visser LH. Sonography in the diagnosis of carpal tunnel syndrome: a critical review of the literature. Muscle Nerve 2003; 27: 26-33.
39 Bianchi S, Martinoli C, Montet X, Fasel JHD. Hand-und Handwurzel-Ultraschall. Radiologe 2003; 43: 831-40.
40 Martinoli C, Bianchi S, Gandolfo N, Valle M, Simonetti S, Derchi LE. US of nerve entrapments in osteofibrous tunnels of the upper and lower limbs. RadioGraphics 2000; 20: s199-s217.
41 Backhaus M, Kamradt T, Sandrock D, Loreck D. et al. Arthritis of the finger joints: a comprehensive approach comparing conventional radiography, scintigraphy, ultrasound, and contrast-enhanced magnetic resonance imaging. Arthritis Rheum 1999; 42: 1232-45.
42 Nakamichi K-I, Tachibana S. Distance between the median nerve and ulnar neurovascular bundle: clinical significance with ultrasonographically assisted carpal tunnel release. J Hand Surg (Am) 1998; 23: 870-4.
43 Campbell WW. Ulnar neuropathy at the elbow. Muscle Nerve 2000; 23: 450-2.
44 Mumenthaler M. Die Ulnarisparesen. Stuttgart: Thieme Verlag; 1961: 279-315.
45 Martinoli C, Bianchi S, Pugliese F, Bacigalupo L. et al. Sonography of entrapment neuropathies in the upper limb (wrist excluded). J Clin Ultrasound 2004; 32: 438-50.
46 Martinoli C, Bianchi S, Giovagnorio F, Pugliese F. Ultrasound of the elbow. Skeletal Radiol 2001; 30: 605-14.
47 Beekman R, Schoemaker MC, van der Plas JPL, van den Berg LH. et al. Diagnostic value of highresolution sonography in ulnar neuropathy at the elbow. Neurology 2004; 62: 767-73.
48 Peeters EY, Nieboer KH, Osteaux MM. Sonography of the normal ulnar nerve at Guyon’s canal and of the common peroneal nerve dorsal to the fibular head. J Clin Ultrasound 2004; 32: 375-80.
49 Chien AJ, Jamadar DA, Jacobson JA, Hayes CW, Louis DS. Sonography and MR imaging of posterior interosseous nerve syndrome with surgical correlation. AJR Am J Roentgenol 2003; 181: 219-21.
50 Bodner G, Buchberger W, Schocke M, Bale R. et al. Radial nerve palsy associated with humeral shaft fracture: evaluation with US – initial experience. Radiology 2001; 219: 811-6.
51 Mahlfeld K, Kayser R, Franke J. Sonographische Diagnosestellung einer Baker-Zyste als Ursache einer Peroneusparese bei einem Patienten mit Rheumatoidarthritis. Unfallchirurg 2004; 107: 429-32.
52 Quinn TJ, Jacobson JA, Craig JG, van Holsbeeck MT. Sonography of Morton’s neuromas. AJR Am J Roentgenol 2000; 174: 1723-8.
53 Beggs I. Sonographic appearances of nerve tumors. J Clin Ultrasound 1999; 27: 363-8.
54 Bendix N, Wolf C, Gruber H, Bodner G. Sonographisches Bildessay: Periphere Nerventumoren. Ultraschall Med 2005; 26: 318-24.
55 Martinoli C, Schenone A, Bianchi S, Mandich P. et al. Sonography of the median nerve in Charcot Marie-Tooth disease. AJR Am J Roentgenol 2002; 178: 1553-6.
56 Matsuoka N, Kohriyama T, Ochi K, Nishitani M. et al. Detection of cervical nerve root hypertrophy by ultrasonography in chronic inflammatory demyelinating polyradiculopathy. J Neurol Sci 2004; 219: 15-21.
57 Gruber H, Peer S, Meirer S, Bodner G. Peroneal nerve palsy associated with knee luxation: evaluation by sonography– initial experiences. AJR Am J Roentgenol 2005; 185: 1119-25.
58 Martinoli C, Bianchi S, Dahmane M, Pugliese F, Bianchi-Zamorani M, Valle M. Ultrasound of tendons and nerves. Eur Radiol 2002; 12: 44-55.
59 Peer S, Bodner G, Meirer R, Willeit J, Piza-Katzer H. Examination of postoperative peripheral nerve lesions with high-resolution sonography. AJR Am J Roentgenol 2001; 177: 415-9.