Application of magnetic resonance neuroimaging in determining the relationship between tumors and peripheral nerves

Magnetic resonance imaging (MRI) is commonly used to analyze the relationship between tumors and nerves before surgery. However, the application value of diffusion tensor imaging (DTI), diffusion weighted imaging (DWI), and post-processing techniques needs further elucidation.

To assess the value of DTI, DWI, and various post-processing techniques in determining the relationship between tumors and nerves.

The participants were 42 patients diagnosed with peripheral nerve-related tumors and 20 healthy controls. DTI and DWI scans were performed before surgery, and then DTI unidirectional maximum intensity projection (MIP) post-processing and DWI subtraction of unidirectionally encoded images for suppression of heavily isotropic objects (DWI_SUSHI) postprocessing techniques were used to observe the relationship between the mass and the target nerves. The mean apparent diffusion coefficient (ADC) of nerves was compared among the target neural origin group, non-target neural origin group, and healthy control group using the paired Wilcoxon rank-sum test.

The diagnostic coincidence rates of preoperative DTI and DWI findings with postoperative pathology were 88.1% and 100%, respectively. DTI images were of poor quality when compared to DWI_SUSHI (P < 0.05). The mean ADC value of the target neural origin group was greater than that of the non-target neural origin group and the healthy control group (P < 0.05).

Both DTI and DWI_SUSHI can stereoscopically display the relationship between peripheral nerves and tumors, but the latter contributes to better quality of the reconstructed images.