1. 7T MR neurography‐ultrasound fusion for peripheral nerve imaging
- Author
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Alexander Grimm, Frank Schreiber, Alica Peter, Marc Dörner, Stefanie Schreiber, Peter J. Nestor, Suanne Petri, Stefan Vielhaber, Eser Isler, Hans-Jochen Heinze, and Claus Tempelmann
- Subjects
0301 basic medicine ,Pathology ,medicine.medical_specialty ,Physiology ,Inflammation ,030105 genetics & heredity ,Guillain-Barre Syndrome ,Peripheral axonal degeneration ,Multimodal Imaging ,Young Adult ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,methods [Magnetic Resonance Imaging] ,0302 clinical medicine ,Charcot-Marie-Tooth Disease ,Physiology (medical) ,medicine ,Humans ,ddc:610 ,Tibial nerve ,Ultrasonography ,blood supply [Tibial Nerve] ,methods [Multimodal Imaging] ,business.industry ,Magnetic resonance neurography ,diagnostic imaging [Charcot-Marie-Tooth Disease] ,methods [Ultrasonography] ,Ultrasound ,diagnostic imaging [Guillain-Barre Syndrome] ,Polyradiculoneuropathy ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,diagnostic imaging [Tibial Nerve] ,medicine.anatomical_structure ,Regional Blood Flow ,Peripheral nervous system ,fusion imaging ,microvascular blood flow ,CMT1A ,ultrasound ,magnetic resonance neurography ,Female ,Neurology (clinical) ,Tibial Nerve ,Ankle ,medicine.symptom ,physiology [Regional Blood Flow] ,business ,030217 neurology & neurosurgery - Abstract
BACKGROUND: We present one patient with an initial diagnosis of Guillain-Barré syndrome (GBS) and one with Charcot-Marie-Tooth disease (CMT) type 1A. METHODS: Both patients underwent ankle tibial nerve fusion-imaging of high-resolution ultrasound (HRUS) with 7T MR neurography (MRN). RESULTS: In GBS, the nerve was enlarged, T2-hyperintense, and showed increased vascularization 21 months after symptom onset. In CMT1A, the enlarged nerve was T2-isointense with normal endoneurial blood flow. CONCLUSIONS: We demonstrate the utility of 7T-MRN-HRUS-fusion-imaging. In GBS, there was evidence of ongoing inflammation resulting in a changed diagnosis to acute-onset chronic demyelinating polyradiculoneuropathy and maintenance of immunotherapy. By MRN-HRUS-fusion, patients with presumed peripheral axonal degeneration could be shown to display imaging markers associated with peripheral nervous system inflammation. Thus, more accurate identification of a treatable inflammatory component may become possible.
- Published
- 2020