Radiologische Diagnostik typischer peripherer Nervenengpasssyndrome: Teil 1: Allgemeines

Im Gegensatz zum Karpaltunnelsyndrom sind die anderen peripheren Nervenengpasssyndrome selten und vielfach nicht bekannt. Häufig sind sie Zufallsbefunde bei einer MRT-Untersuchung aus einem anderen Grund. In diesem Beitrag sollen die Ursachen, die Pathogenese und die entscheidenden radiologischen Befunde bei peripheren Engpasssyndromen vorgestellt und erläutert werden.

Abstract

In contrary to the carpal tunnel syndrome, other peripheral nerve entrapments are rare and radiologists are therefore not familiar with these entities. Frequently, nerve impingements turn out to be unexpected findings when MRI isperformed for other reasons. In this article, causes, pathogenesis, and hallmark radiological findings of peripheral nerve entrapment syndromes will be presented and further discussed.

Schlüsselwörter

Nervenengpasssyndrom - Impingement - kompressive Neuropathie - Muskeldenervierung - MRT

Keywords

Entrapment - Impingement - compressive neuropathy - muscle denervation - MRI

• Literatur

• 1 Assmus H, Antoniadis G, Bischoff C. Carpal and cubital tunnel and other rare nerve compression syndromes. Dtsch Arztebl Int 2015; 112: 14-26
• 2 Hochman MG, Zilberfarb JL. Nerves in a pinch: imaging of nerve compression syndromes. Radiol Clin N Am 2004; 42: 221-245
• 3 Chhabra A, Flammang A, Padua A. et al. Magnetic resonance neurography: technical considerations. Neuroimaging Clin N Am 2014; 24: 67-78
• 4 Bashir W, Connell D. Imaging of entrapment and compressive neuropathies. Semin Muskuloskelet Radiol 2008; 12: 170-181
• 5 Kao D, Cheng J. Peripheral neuropathy: Surgical approaches simplified for the imagers. Semin Musculoskelet Radiol 2015; 19: 121-129
• 6 Thatte MR, Mansukhani KA. Compressive neuropathy in the upper limb. Indian J Plast Surg 2011; 4: 283-297
• 7 Beltran LS, Bencardino J, Ghazikhanian V. et al. Entrapment neuropathies III: lower limb. Semin Musculoskelet Radiol 2010; 14: 501-511
• 8 Broadhurst PK, Robinson LR. Compartment syndrome: neuromuscular complications and electrodiagnosis. Muscle Nerve 2020; 62: 300-308
• 9 Tapadia M, Mozaffar T, Gupta R. Compressive neuropathies of the Upper extremity: pathophysiology, classification, electrodiagnostic findings. J Hand Surg Am 2010; 35: 668-677
• 10 Mackinnon SE. Pathophysiology of nerve compression. Hand Clin 2002; 18: 231-241
• 11 Schmid AB, Fundaun J, Tampin B. Entrapment neuropathies: a contemporary approach to pathophysiology, clinical assessment, and management. Pain Rep 2020; 5: e829
• 12 Kamath S, Venkatanarasimha N, Walsh MA. et al. MRI appearance of muscle denervation. Skeletal Radiol 2008; 37: 397-404
• 13 Bendszus M, Koltzenburg M, Wessig C. et al. Sequential MR Imaging of denervated muscle: experimental study. AJNR Am J Neuroradiol 2002; 23: 1427-1432
• 14 Bogdanov J, Lan R, Chu TN. et al. Fatty degeneration of the rotator cuff: pathogenesis, clinical implications, and future treatment. JSES Rev Rep Tech 2021; 1: 301-308
• 15 Beeler S, Ek ETH, Gerber C. A comparative analysis of fatty infiltration and muscle atrophy in patients with chronic rotator cuff tears and suprascapular neuropathy. J Shoulder Elbow Surg 2013; 22: 1537-1546
• 16 McMahon CJ, Wu JS, Eisenberg RL. Muscle edema. AJR Am J Roentgenol 2010; 194: W284-W292
• 17 West AG, Haynor DR, Goodkin R. et al. Magnetic resonance imaging signal changes in denervated muscles after peripheral nerve injury. Neurosurgery 1994; 35: 1077-1086
• 18 Kamath S, Venkatanarasimha N, Walsh MA. et al. MRI appearance of muscle denervation. Skeletal Radiol 2008; 37: 397-404
• 19 McMahon CJ, Wu JS, Eisenberg RL. Muscle edema. AJR Am J Roentgenol 2010; 194: W284-W292
• 20 Kim S, Choi JY, Huh YM. et al. Role of magnetic resonance imaging in entrapment and compressive neuropathy – what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 1. Overview and lower extremity. Eur Radiol 2007; 17: 139-149
• 21 Kim S, Choi JY, Huh YM. et al. Role of magnetic resonance imaging in entrapment and compressive neuropathy – what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 2. Upper extremity. Eur Radiol 2007; 17: 509-522
• 22 Martín Noguerol T, Barousse R. Update in the evaluation of peripheral nerves by MRI, from morphological to functional neurography. Radiologia (Engl Ed) 2020; 62: 90-101
• 23 Thawait SK, Chaudhry V, Thawait GK. et al. High-resolution MR neurography of diffuse peripheral nerve lesions. AJNR Am J Neuroradiol 2011; 32: 1365-1372
• 24 Xu Z, Zhang T, Chan J. et al. Combine contrast-enhanced 3D T2-weighted short inversion time inversion recovery MR neurography with MR angiography at 1.5 T in the assessment of brachial plexopathy. MAGMA 2021; 34: 229-239
• 25 Zare M, Faeghi F, Hosseini A. et al. Comparison between three-dimensional diffusion weighted PSIF technique and routine imaging sequences in evaluation of peripheral nerves in healthy people. Basic Clin Neurosci 2018; 9: 65-71
• 26 Holzgrefe RE, Wagner ER, Singer AD. et al. Imaging of peripheral nerve: Concepts and future direction of magnetic resonance neurography and ultrasound. J Hand Surg 2019; 44: 1066-1079
• 27 Martín Noguerol T, Montesinos P, Hassangkhani A. et al. Technical update on MR neurography. Semin Musculoskelet Radiol 2022; 26: 93-104
• 28 Harrell AD, Johnson D, Samet J. et al. With or without? A retrospective analysis of intravenous contrast utility in magnetic resonance neurography. Skeletal Radiol 2020; 49: 577-584
• 29 Kirchgesner T, Acid S, Perlepe V. et al. Two-point Dixon fat-water swapping artifact: lesion mimicker at musculoskeletal T2-weigthed MRI. Skeletal Radiol 2020; 49: 2081-2086