Diffusion tensor imaging MR neurography in patients with acute or chronic plexopathy

Area of Science:

• Radiology
• Neurology
• Medical Imaging

Background:

• Nerve plexuses are vulnerable to pathological processes.
• Magnetic resonance neurography (MRN) aids in characterizing plexus involvement.
• The clinical utility of diffusion tensor imaging (DTI) for nerve plexuses is not well-established.

Purpose of the Study:

• To evaluate the added value of DTI in routine MRN protocols for patients with plexopathy.
• To assess DTI's impact on the diagnostic workup of acute and chronic plexopathies.

Main Methods:

• Retrospective analysis of 3T MRN including DTI in patients with plexopathy (2014-2020).
• Co-registration of DTI and conventional MRN images.
• Consensus review by two neuroradiologists and one neurologist to identify cases with diagnostic impact.

Main Results:

• DTI improved detection of plexus signal/morphological abnormalities compared to conventional MRN.
• DTI provided additional information on nerve fiber microarchitecture via DTI metrics.
• DTI showed potential as an alternative to gadolinium contrast in some cases.

Conclusions:

• Diffusion tensor imaging (DTI) offers significant advantages in characterizing nerve plexus pathologies.
• DTI enhances diagnostic accuracy by improving visualization and providing microstructural information.
• The findings support the routine implementation of DTI in MRN protocols for plexopathy evaluation.