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22.09.2015 | Musculoskeletal

Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management

verfasst von: Avneesh Chhabra, Allan J Belzberg, Gedge D Rosson, Gaurav K Thawait, M Chalian, Sahar J Farahani, Jaimie T Shores, Gene Deune, Shar Hashemi, Shrey K Thawait, Ty K Subhawong, John A Carrino

Erschienen in: European Radiology | Ausgabe 5/2016

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Abstract

Objective

To evaluate the impact of magnetic resonance neurography (MRN) on diagnostic thinking and therapeutic choices in patients with suspected peripheral neuropathy.

Methods

IRB approval was obtained for this HIPAA-compliant study. Questionnaires were administered to six surgeons regarding the diagnosis and treatment in 85 patients suspected of having peripheral neuropathy, before (pretest) and after (posttest) MRN. Multiple outcome measures related to diagnostic confidence and surgical decision-making were assessed.

Results

The final cohort included 81 patients (30 men and 51 women, age 47 ± 17 years). The following changes were observed from pretest to posttest questionnaires: 23 % in nerve involvement (P < 0.05), 48 % in degree of confidence of nerve involvement (P < 0.01), 27 % in grade of injury (P < 0.05), 33 % in differential diagnosis (P < 0.05), 63 % in degree of confidence in need for surgery (P < 0.001), 41 % in timing of surgery (P < 0.01), 30 % in approach to surgery (P < 0.05), 58 % in degree of confidence in approach to surgery (P < 0.001), 30 % in estimated length of surgery (P < 0.05) and 27 % in length of incision (P < 0.05). The dichotomous decision regarding surgical or nonsurgical treatment changed from pro to con in 17 %.

Conclusion

MRN results significantly influenced the diagnostic thinking and therapeutic recommendations of peripheral nerve surgeons.

Key Points

• In patients with peripheral neuropathy, MRN significantly impacts diagnostic thinking.

• In patients with peripheral neuropathy, MRN significantly impacts therapeutic choices.

• 3-T MRN should be considered in presurgical planning of patients with peripheral neuropathy.

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Titel: Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management
verfasst von: Avneesh Chhabra
Allan J Belzberg
Gedge D Rosson
Gaurav K Thawait
M Chalian
Sahar J Farahani
Jaimie T Shores
Gene Deune
Shar Hashemi
Shrey K Thawait
Ty K Subhawong
John A Carrino
Publikationsdatum: 22.09.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 5/2016
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3958-y

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Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management

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Objective

Methods

Results

Conclusion

Key Points

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