Skip to main content
Erschienen in: European Radiology 7/2019

22.03.2019 | Neuro

Prevalence of fascicular hyperintensities in peripheral nerves of healthy individuals with regard to cerebral white matter lesions

Erschienen in: European Radiology | Ausgabe 7/2019

Einloggen, um Zugang zu erhalten

Abstract

Objective

Detection and pattern analysis of fascicular nerve hyperintensities in the T2-weighted image are the backbone of magnetic resonance neurography (MRN) as they may represent lesions of various etiologies. The aim of this study was to assess the prevalence of fascicular nerve hyperintensities in healthy individuals with regard to a potential association with age or cerebral white matter lesions.

Methods

Sixty volunteers without peripheral nerve diseases between the age of 20 and 80 underwent MRN (high-resolution T2-weighted) of upper (median, ulnar, radial) and lower (sciatic, tibial) extremity nerves and a fluid-attenuated inversion recovery (FLAIR) sequence of the brain. Presence of peripheral nerve hyperintensities and degree of cerebral white matter lesions were independently rated by two blinded readers and related to each other and to age. T test with Welch’s correction was used for group comparisons. Spearman’s correlation coefficients were reported for correlation analyses.

Results

MR neurography revealed fascicular hyperintensities in 10 of 60 subjects (16.7%). Most frequently, they occurred in the sciatic nerve (8/60 subjects, 13.3%), less frequently in the tibial nerve at the lower leg and the median, ulnar, and radial nerves at the upper arm (1.7–5.0%). Mean age of subjects with nerve hyperintensities was higher than that of those without (60.6 years vs. 48.0 years, p = 0.038). There was only a weak correlation of nerve lesions with age and with cerebral white matter lesions, respectively.

Conclusion

Fascicular nerve hyperintensities may occur in healthy individuals and should therefore always be regarded in conjunction with the clinical context.

Key Points

• MR neurography may reveal fascicular hyperintensities in peripheral nerves of healthy individuals. Fascicular hyperintensities occur predominantly in the sciatic nerve and older individuals.
• Therefore, fascicular hyperintensities should only be interpreted as clearly pathologic in conjunction with the clinical context.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Chhabra A, Andreisek G, Soldatos T et al (2011) MR neurography: past, present, and future. AJR Am J Roentgenol 197:583–591CrossRefPubMed Chhabra A, Andreisek G, Soldatos T et al (2011) MR neurography: past, present, and future. AJR Am J Roentgenol 197:583–591CrossRefPubMed
2.
Zurück zum Zitat Kollmer J, Bendszus M, Pham M (2015) MR neurography: diagnostic imaging in the PNS. Clin Neuroradiol 25(Suppl 2):283–289CrossRefPubMed Kollmer J, Bendszus M, Pham M (2015) MR neurography: diagnostic imaging in the PNS. Clin Neuroradiol 25(Suppl 2):283–289CrossRefPubMed
4.
Zurück zum Zitat Kronlage M, Pitarokoili K, Schwarz D et al (2017) Diffusion tensor imaging in chronic inflammatory demyelinating polyneuropathy: diagnostic accuracy and correlation with electrophysiology. Invest Radiol 52:701–707CrossRefPubMed Kronlage M, Pitarokoili K, Schwarz D et al (2017) Diffusion tensor imaging in chronic inflammatory demyelinating polyneuropathy: diagnostic accuracy and correlation with electrophysiology. Invest Radiol 52:701–707CrossRefPubMed
5.
Zurück zum Zitat Kronlage M, Bäumer P, Pitarokoili K et al (2017) Large coverage MR neurography in CIDP: diagnostic accuracy and electrophysiological correlation. J Neurol 264:1434–1443CrossRefPubMed Kronlage M, Bäumer P, Pitarokoili K et al (2017) Large coverage MR neurography in CIDP: diagnostic accuracy and electrophysiological correlation. J Neurol 264:1434–1443CrossRefPubMed
6.
Zurück zum Zitat Godel T, Bäumer P, Pham M et al (2017) Human dorsal root ganglion in vivo morphometry and perfusion in Fabry painful neuropathy. Neurology 89:1274–1282CrossRefPubMed Godel T, Bäumer P, Pham M et al (2017) Human dorsal root ganglion in vivo morphometry and perfusion in Fabry painful neuropathy. Neurology 89:1274–1282CrossRefPubMed
7.
Zurück zum Zitat Hiltunen J, Kirveskari E, Numminen J, Lindfors N, Göransson H, Hari R (2012) Pre- and post-operative diffusion tensor imaging of the median nerve in carpal tunnel syndrome. Eur Radiol 22:1310–1319CrossRefPubMed Hiltunen J, Kirveskari E, Numminen J, Lindfors N, Göransson H, Hari R (2012) Pre- and post-operative diffusion tensor imaging of the median nerve in carpal tunnel syndrome. Eur Radiol 22:1310–1319CrossRefPubMed
8.
Zurück zum Zitat Haakma W, Jongbloed BA, Froeling M et al (2017) MRI shows thickening and altered diffusion in the median and ulnar nerves in multifocal motor neuropathy. Eur Radiol 27:2216–2224CrossRefPubMed Haakma W, Jongbloed BA, Froeling M et al (2017) MRI shows thickening and altered diffusion in the median and ulnar nerves in multifocal motor neuropathy. Eur Radiol 27:2216–2224CrossRefPubMed
9.
Zurück zum Zitat Wu C, Wang G, Zhao Y et al (2017) Assessment of tibial and common peroneal nerves in diabetic peripheral neuropathy by diffusion tensor imaging: a case control study. Eur Radiol 27:3523–3531CrossRefPubMed Wu C, Wang G, Zhao Y et al (2017) Assessment of tibial and common peroneal nerves in diabetic peripheral neuropathy by diffusion tensor imaging: a case control study. Eur Radiol 27:3523–3531CrossRefPubMed
10.
Zurück zum Zitat Kronlage M, Schwehr V, Schwarz D et al (2018) Peripheral nerve diffusion tensor imaging (DTI): normal values and demographic determinants in a cohort of 60 healthy individuals. Eur Radiol 28:1801–1808CrossRefPubMed Kronlage M, Schwehr V, Schwarz D et al (2018) Peripheral nerve diffusion tensor imaging (DTI): normal values and demographic determinants in a cohort of 60 healthy individuals. Eur Radiol 28:1801–1808CrossRefPubMed
11.
Zurück zum Zitat Chhabra A, Belzberg AJ, Rosson GD et al (2016) Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management. Eur Radiol 26:1235–1244CrossRefPubMed Chhabra A, Belzberg AJ, Rosson GD et al (2016) Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management. Eur Radiol 26:1235–1244CrossRefPubMed
12.
Zurück zum Zitat Pham M, Oikonomou D, Hornung B et al (2015) Magnetic resonance neurography detects diabetic neuropathy early and with proximal predominance. Ann Neurol 78:939–948CrossRefPubMedPubMedCentral Pham M, Oikonomou D, Hornung B et al (2015) Magnetic resonance neurography detects diabetic neuropathy early and with proximal predominance. Ann Neurol 78:939–948CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Kollmer J, Hund E, Hornung B et al (2015) In vivo detection of nerve injury in familial amyloid polyneuropathy by magnetic resonance neurography. Brain 138:549–562CrossRefPubMed Kollmer J, Hund E, Hornung B et al (2015) In vivo detection of nerve injury in familial amyloid polyneuropathy by magnetic resonance neurography. Brain 138:549–562CrossRefPubMed
14.
Zurück zum Zitat Chhabra A, Carrino JA, Farahani SJ et al (2016) Whole-body MR neurography: prospective feasibility study in polyneuropathy and Charcot-Marie-Tooth disease. J Magn Reson Imaging 44:1513–1521CrossRefPubMed Chhabra A, Carrino JA, Farahani SJ et al (2016) Whole-body MR neurography: prospective feasibility study in polyneuropathy and Charcot-Marie-Tooth disease. J Magn Reson Imaging 44:1513–1521CrossRefPubMed
15.
Zurück zum Zitat Upadhyaya V, Upadhyaya DN, Mishra B (2018) MR neurography in traumatic, non-obstetric paediatric brachial plexopathy. Eur Radiol 28:2417–2424CrossRefPubMed Upadhyaya V, Upadhyaya DN, Mishra B (2018) MR neurography in traumatic, non-obstetric paediatric brachial plexopathy. Eur Radiol 28:2417–2424CrossRefPubMed
16.
Zurück zum Zitat Breitenseher JB, Kranz G, Hold A et al (2015) MR neurography of ulnar nerve entrapment at the cubital tunnel: a diffusion tensor imaging study. Eur Radiol 25:1911–1918CrossRefPubMed Breitenseher JB, Kranz G, Hold A et al (2015) MR neurography of ulnar nerve entrapment at the cubital tunnel: a diffusion tensor imaging study. Eur Radiol 25:1911–1918CrossRefPubMed
17.
Zurück zum Zitat Thawait SK, Chaudhry V, Thawait GK et al (2011) High-resolution MR neurography of diffuse peripheral nerve lesions. AJNR Am J Neuroradiol 32:1365–1372CrossRefPubMedPubMedCentral Thawait SK, Chaudhry V, Thawait GK et al (2011) High-resolution MR neurography of diffuse peripheral nerve lesions. AJNR Am J Neuroradiol 32:1365–1372CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Pham M, Baumer T, Bendszus M (2014) Peripheral nerves and plexus: imaging by MR-neurography and high-resolution ultrasound. Curr Opin Neurol 27:370–379CrossRefPubMed Pham M, Baumer T, Bendszus M (2014) Peripheral nerves and plexus: imaging by MR-neurography and high-resolution ultrasound. Curr Opin Neurol 27:370–379CrossRefPubMed
19.
Zurück zum Zitat Bendszus M, Stoll G (2005) Technology insight: visualizing peripheral nerve injury using MRI. Nat Clin Pract Neurol 1:45–53CrossRefPubMed Bendszus M, Stoll G (2005) Technology insight: visualizing peripheral nerve injury using MRI. Nat Clin Pract Neurol 1:45–53CrossRefPubMed
20.
Zurück zum Zitat Husarik DB, Saupe N, Pfirrmann CW, Jost B, Hodler J, Zanetti M (2009) Elbow nerves: MR findings in 60 asymptomatic subjects--normal anatomy, variants, and pitfalls. Radiology 252:148–156CrossRefPubMed Husarik DB, Saupe N, Pfirrmann CW, Jost B, Hodler J, Zanetti M (2009) Elbow nerves: MR findings in 60 asymptomatic subjects--normal anatomy, variants, and pitfalls. Radiology 252:148–156CrossRefPubMed
21.
Zurück zum Zitat Hentschel F, Damian M, Krumm B, Froelich L (2007) White matter lesions - age-adjusted values for cognitively healthy and demented subjects. Acta Neurol Scand 115:174–180CrossRefPubMed Hentschel F, Damian M, Krumm B, Froelich L (2007) White matter lesions - age-adjusted values for cognitively healthy and demented subjects. Acta Neurol Scand 115:174–180CrossRefPubMed
22.
Zurück zum Zitat Ylikoski A, Erkinjuntti T, Raininko R, Sarna S, Sulkava R, Tilvis R (1995) White matter hyperintensities on MRI in the neurologically nondiseased elderly. Analysis of cohorts of consecutive subjects aged 55 to 85 years living at home. Stroke 26:1171–1177CrossRefPubMed Ylikoski A, Erkinjuntti T, Raininko R, Sarna S, Sulkava R, Tilvis R (1995) White matter hyperintensities on MRI in the neurologically nondiseased elderly. Analysis of cohorts of consecutive subjects aged 55 to 85 years living at home. Stroke 26:1171–1177CrossRefPubMed
23.
Zurück zum Zitat Garde E, Mortensen EL, Krabbe K, Rostrup E, Larsson HB (2000) Relation between age-related decline in intelligence and cerebral white-matter hyperintensities in healthy octogenarians: a longitudinal study. Lancet 356:628–634CrossRefPubMed Garde E, Mortensen EL, Krabbe K, Rostrup E, Larsson HB (2000) Relation between age-related decline in intelligence and cerebral white-matter hyperintensities in healthy octogenarians: a longitudinal study. Lancet 356:628–634CrossRefPubMed
24.
Zurück zum Zitat Fazekas F, Schmidt R, Scheltens P (1998) Pathophysiologic mechanisms in the development of age-related white matter changes of the brain. Dement Geriatr Cogn Disord 9(Suppl 1):2–5CrossRefPubMed Fazekas F, Schmidt R, Scheltens P (1998) Pathophysiologic mechanisms in the development of age-related white matter changes of the brain. Dement Geriatr Cogn Disord 9(Suppl 1):2–5CrossRefPubMed
25.
Zurück zum Zitat Haller S, Kövari E, Herrmann FR et al (2013) Do brain T2/FLAIR white matter hyperintensities correspond to myelin loss in normal aging? A radiologic-neuropathologic correlation study. Acta Neuropathol Commun 1:14CrossRefPubMedPubMedCentral Haller S, Kövari E, Herrmann FR et al (2013) Do brain T2/FLAIR white matter hyperintensities correspond to myelin loss in normal aging? A radiologic-neuropathologic correlation study. Acta Neuropathol Commun 1:14CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat de Leeuw FE, de Groot JC, Achten E et al (2001) Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. The Rotterdam Scan Study. J Neurol Neurosurg Psychiatry 70:9–14CrossRefPubMedPubMedCentral de Leeuw FE, de Groot JC, Achten E et al (2001) Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. The Rotterdam Scan Study. J Neurol Neurosurg Psychiatry 70:9–14CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Longstreth WT Jr, Manolio TA, Arnold A et al (1996) Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people. The Cardiovascular Health Study. Stroke 27:1274–1282CrossRefPubMed Longstreth WT Jr, Manolio TA, Arnold A et al (1996) Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people. The Cardiovascular Health Study. Stroke 27:1274–1282CrossRefPubMed
28.
Zurück zum Zitat Larkman N, Lefebvre G, Jacques T, Demondion X, Cotten H, Cotten A (2017) Anatomical and MR correlative study of the proximal sciatic nerve vasculature. Br J Radiol 90:20170031CrossRefPubMedPubMedCentral Larkman N, Lefebvre G, Jacques T, Demondion X, Cotten H, Cotten A (2017) Anatomical and MR correlative study of the proximal sciatic nerve vasculature. Br J Radiol 90:20170031CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat Chappell KE, Robson MD, Stonebridge-Foster A et al (2004) Magic angle effects in MR neurography. AJNR Am J Neuroradiol 25:431–440PubMedPubMedCentral Chappell KE, Robson MD, Stonebridge-Foster A et al (2004) Magic angle effects in MR neurography. AJNR Am J Neuroradiol 25:431–440PubMedPubMedCentral
30.
Zurück zum Zitat Chhabra A, Madhuranthakam AJ, Andreisek G (2018) Magnetic resonance neurography: current perspectives and literature review. Eur Radiol 28:698–707CrossRefPubMed Chhabra A, Madhuranthakam AJ, Andreisek G (2018) Magnetic resonance neurography: current perspectives and literature review. Eur Radiol 28:698–707CrossRefPubMed
31.
Zurück zum Zitat Bendszus M, Rieckmann P, Perez J, Koltzenburg M, Reiners K, Solymosi L (2003) Painful vascular compression syndrome of the sciatic nerve caused by gluteal varicosities. Neurology 61:985–987CrossRefPubMed Bendszus M, Rieckmann P, Perez J, Koltzenburg M, Reiners K, Solymosi L (2003) Painful vascular compression syndrome of the sciatic nerve caused by gluteal varicosities. Neurology 61:985–987CrossRefPubMed
32.
Zurück zum Zitat Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA (1987) MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJR Am J Roentgenol 149:351–356CrossRefPubMed Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA (1987) MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJR Am J Roentgenol 149:351–356CrossRefPubMed
33.
Zurück zum Zitat Brinjikji W, Luetmer PH, Comstock B et al (2015) Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol 36:811–816CrossRefPubMedPubMedCentral Brinjikji W, Luetmer PH, Comstock B et al (2015) Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol 36:811–816CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Debette S, Markus HS (2010) The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ 341:c3666CrossRefPubMedPubMedCentral Debette S, Markus HS (2010) The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ 341:c3666CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Pantoni L, Garcia JH (1995) The significance of cerebral white matter abnormalities 100 years after Binswanger’s report. A review. Stroke 26:1293–1301CrossRefPubMed Pantoni L, Garcia JH (1995) The significance of cerebral white matter abnormalities 100 years after Binswanger’s report. A review. Stroke 26:1293–1301CrossRefPubMed
36.
Zurück zum Zitat Pantoni L (2010) Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol 9:689–701CrossRefPubMed Pantoni L (2010) Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol 9:689–701CrossRefPubMed
37.
Zurück zum Zitat Titelbaum DS, Frazier JL, Grossman RI et al (1989) Wallerian degeneration and inflammation in rat peripheral nerve detected by in vivo MR imaging. AJNR Am J Neuroradiol 10:741–746PubMedPubMedCentral Titelbaum DS, Frazier JL, Grossman RI et al (1989) Wallerian degeneration and inflammation in rat peripheral nerve detected by in vivo MR imaging. AJNR Am J Neuroradiol 10:741–746PubMedPubMedCentral
38.
Zurück zum Zitat Bendszus M, Wessig C, Solymosi L, Reiners K, Koltzenburg M (2004) MRI of peripheral nerve degeneration and regeneration: correlation with electrophysiology and histology. Exp Neurol 188:171–177CrossRefPubMed Bendszus M, Wessig C, Solymosi L, Reiners K, Koltzenburg M (2004) MRI of peripheral nerve degeneration and regeneration: correlation with electrophysiology and histology. Exp Neurol 188:171–177CrossRefPubMed
39.
Zurück zum Zitat Stanisz GJ, Midha R, Munro CA, Henkelman RM (2001) MR properties of rat sciatic nerve following trauma. Magn Reson Med 45:415–420CrossRefPubMed Stanisz GJ, Midha R, Munro CA, Henkelman RM (2001) MR properties of rat sciatic nerve following trauma. Magn Reson Med 45:415–420CrossRefPubMed
40.
Metadaten
Titel
Prevalence of fascicular hyperintensities in peripheral nerves of healthy individuals with regard to cerebral white matter lesions
Publikationsdatum
22.03.2019
Erschienen in
European Radiology / Ausgabe 7/2019
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06145-4

Weitere Artikel der Ausgabe 7/2019

European Radiology 7/2019 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.