Magnetic resonance imaging of the peripheral nervous system

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J Neurol. 2009 Mar 1.

Magnetic resonance imaging of the peripheral nervous system.

Stoll G, Bendszus M, J, Pham M.

Department of Neurology, University of Würzburg, f-Schneider-Str. 11, 97080,

Würzburg, Germany

The diagnostic work up of patients with peripheral neuropathy largely depends on

clinical and electrophysiological investigations. In contrast to disorders of

the CNS, magnetic resonance imaging (MRI) has not been widely used as a

diagnostic tool in the PNS except for detection of nerve compressing mass

lesions.

Normal nerves appear isointense to the surrounding tissue on T1- and T2-weighted

(w) MRIs, but upon injury the nerves become hyperintense and thus visible on

T2-w MRI. These signal alterations can be exploited to diagnose nerve damage in

vivo and to follow regeneration.

In patients with peripheral nerve disorders, MRI has been especially useful in

detecting focal intrinsic and extrinsic nerve lesions and may reveal treatable

conditions even in the absence of gross electrophysiological alterations. This

clinical review provides practical guidelines on the performance of nerve

imaging by MRI and will focus on focal lesions exemplified by case

presentations.