Diffusion tensor imaging to visualize axons in the setting of nerve injury and recovery

Neurosurgical Focus
Thomas Anthony GallagherMichel Kliot

Abstract

Successful management of peripheral nerve trauma relies on accurate localization of the injury and grading of the severity of nerve injury to determine whether surgical intervention is required. Existing techniques, such as electrodiagnostic studies and conventional imaging modalities, provide important information, but are limited by being unable to distinguish severe nerve lesions in continuity that will recover from those that will not. Diffusion tensor imaging (DTI) and tractography of peripheral nerves provide a novel technique to localize and grade nerve injury, by assessing the integrity of the nerve fibers across the site of nerve injury. Diffusion tensor imaging and tractography also hold promise as markers of early nerve regeneration, prior to clinical and electrodiagnostic evidence of recovery. In the present review, the techniques of peripheral nerve DTI and tractography are discussed with respect to peripheral nerve trauma, with illustrative cases demonstrating potential roles of these novel approaches.

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Citations

Oct 16, 2015·World Neurosurgery·Zarina S AliViviane Khoury
Sep 24, 2015·Journal of Magnetic Resonance Imaging : JMRI·Neil G SimonMatthew C Kiernan
Sep 11, 2016·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Neil G SimonCraig M Zaidman
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Feb 9, 2019·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Teodoro Martín NoguerolAntonio Luna
Mar 17, 2020·Journal of Neurological Surgery. Part A, Central European Neurosurgery·Tim WendeJürgen Meixensberger
Mar 8, 2017·Journal of Neurology·Neil G SimonMatthew C Kiernan
Aug 15, 2018·Japanese Journal of Radiology·Carmela VisalliIgnazio Salamone

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Methods Mentioned

BETA
artery bypass

Software Mentioned

MedINRIA : Medical Image Navigation and Research Tool
RESOLVE
DSI Studio
INRIA

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