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Rose Du, Kurtis I. Auguste, Cynthia T. Chin, John W. Engstrom and Philip R. Weinstein

M anagement of peripheral nerve disease is often challenged by the characterization and localization of the underlying disease process. The current gold standard for the diagnosis of peripheral nerve disease in addition to the neurological examination is needle EMG and associated NCS. 11 New technology continues to emerge which may serve to supplement the currently available diagnostic techniques. Magnetic resonance neurography is a novel imaging technique in which STIR sequences are used to image spinal and peripheral nerves directly. 3 Magnetic

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Simon A. Cudlip, Franklyn A. Howe, John R. Griffiths and B. Anthony Bell

continuity of the nerve. In six animals the nerve was exposed only (sham operation) on the left side, and in the remaining six animals the left (control) nerve was not exposed. The wounds were then closed and the animals were allowed to recover. Magnetic Resonance Neurography of Sciatic Nerve Images of the control and injured sciatic nerves were obtained at 7, 14, 30, and 70 days in each animal. Before imaging, the rats were anesthetized with an intraperitoneal dose of Hypnorm and midazolam titrated to their weight. They were then placed supine on a custom-made 50-mm

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Simon A. Cudlip, Franklyn A. Howe, Andrew Clifton, Martin S. Schwartz and B. Anthony Bell

; an open procedure was used and in all cases the median nerve was visualized and decompression confirmed. Postoperative outcome was determined by conducting outpatient interviews and through examination by a clinician who was blinded to the imaging and electrophysiological findings. Grading was as follows: excellent, no residual symptoms; good, very mild residual symptoms and improvement in results of sensory and motor examination; fair, improvement but still symptomatic; and poor, no improvement or worse. Magnetic Resonance Neurography Methods All scans

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Matthew D. Bucknor, Lynne S. Steinbach, David Saloner and Cynthia T. Chin

a novel clinical syndrome was described involving patients (often athletes who were sprinters) who presented with several months of sciatica and who reported a remote history of proximal hamstring tear. Complete pain relief was obtained in 52 of 59 patients after surgical division of “tight, tendinous structures” at the lateral proximal origin along the ischial tuberosity, adjacent to the sciatic nerve. 19 Magnetic resonance neurography (MRN) is a powerful tool for imaging peripheral nerves. 6 In contrast to routine MRI of the lumbosacral spine, MRN uses high

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Dilantha B. Ellegala, Stephen J. Monteith, David Haynor, Thomas D. Bird, Robert Goodkin and Michel Kliot

Diagnostics, Worcester, MA). Patients were recruited for the study following the results of this DNA analysis. Magnetic resonance neurography was performed using a standard 1.5-tesla MR imaging system (Signa; General Electric Medical Systems, Milwaukee, WI) and custom-built phased-array imaging surface coils. 4 Axial T 1 -weighted, T 2 -weighted, and short-tau inversion-recovery, fast—spin echo pulse sequences were obtained. Imaging was centered at the mid-thigh level in all patients. The total area of the tibial and peroneal nerves was calculated, and number of the

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Aaron G. Filler, Michel Kliot, Franklyn A. Howe, Cecil E. Hayes, Dawn E. Saunders, Robert Goodkin, B. Anthony Bell, H. Richard Winn, John R. Griffiths and Jay S. Tsuruda

the unanticipated benefit of demonstrating internal fascicular anatomy of the nerve because the signal from the interfascicular epineurium was suppressed along with signals from other nonneural tissues. Magnetic resonance neurography can be defined as tissue-selective imaging directed at identifying and evaluating characteristics of nerve morphology: internal fascicular pattern, longitudinal variations in signal intensity and caliber, and connections and relations to other nerves or plexuses. Abstracts 13, 15, 55 and preliminary works 6, 28 reporting wider

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Aaron G. Filler, Jodean Haynes, Sheldon E. Jordan, Joshua Prager, J. Pablo Villablanca, Keyvan Farahani, Duncan Q. Mcbride, Jay S. Tsuruda, Brannon Morisoli, Ulrich Batzdorf and J. Patrick Johnson

. Magnetic resonance neurography 20, 21, 33 and interventional MR imaging provide greatly enhanced diagnostic capability for the evaluation of entrapment 22 of the proximal sciatic nerve and its precendent neural elements. 19, 49 In this study we assessed the outcomes of both surgical and percutaneous invasive treatments based on the results of these new diagnostic techniques. In addition, a major focus of this study was to address the null hypothesis that nerve-based imaging is unnecessary or unhelpful in the diagnosis and treatment of sciatica. Western medicine is

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Intraneural perineurioma of the common peroneal nerve

Case report and review of the literature

Marta E. Heilbrun, Jay S. Tsuruda, Jeannette J. Townsend and M. Peter Heilbrun

such as demyelination, inflammation, or a mass lesion could be identified. Magnetic resonance neurography involves the use of high-resolution, high signal-to-noise techniques with sufficient image contrast to emphasize peripheral nerve anatomy and morphological characteristics. Such techniques were used to evaluate this patient. Magnetic resonance neurography was performed using a 1.5-tesla clinical imager with high-performance gradients (Signa Nvi/Cvi; General Electric Medical Systems, Milwaukee, WI). Specialized radiofrequency surface-phased-array coils (Median

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Ron Ron Cheng, Ramin Eskandari, Cynthia T. Welsh and Abhay K. Varma

motor amplitude, and conduction velocity slowing after proximal stimulation with normal distal latency in the right radial nerve. These findings were interpreted as a severe distal right radial sensorimotor mononeuropathy. Electromyography (EMG) revealed denervation of muscle groups supplied by the radial nerve distal to the elbow. Electromyographic testing of the right triceps, hand muscles, and biceps was normal. Magnetic resonance neurography (MRN) without contrast of the right upper extremity demonstrated focally increased signal within the radial nerve at the

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Nico Sollmann, Dominik Weidlich, Barbara Cervantes, Elisabeth Klupp, Carl Ganter, Hendrik Kooijman, Claus Zimmer, Ernst J. Rummeny, Bernhard Meyer, Thomas Baum, Jan S. Kirschke and Dimitrios C. Karampinos

, herniated discs were identified by CT or MRI in about 20%–36% of asymptomatic subjects, and symptoms can even resolve under conservative treatment without a detectable volume decrease of the herniated disc in a considerable number of patients. 12 , 20 , 31 Magnetic resonance neurography (MRN) has gained increasing importance as a novel add-on diagnostic tool that enables the identification and characterization of various nerve pathologies. 7 , 9 When performed with advanced high-resolution sequences, MRN can even depict the small and highly oblique nerves of the brachial