Magnetic Resonance Neurography of the Wrist: Tips and Tricks

Magnetic resonance (MR) neurography is MR imaging for peripheral nerve evaluation. In the forearm and wrist specifically, MR neurography may evaluate median, ulnar, and radial neuropathies and may identify conditions such as entrapment, neuritis, and neuroma. MR neurography protocols often include specialized sequences and allow for multiplanar reformatting. In the setting of peripheral neuropathy, the involved nerve is typically isointense to muscle on T1-weighted sequences but may display abnormal intrinsic T2 hyperintense signal, morphologic thickening, and altered fascicular architecture. At the wrist, the median nerve is most vulnerable in the carpal tunnel while the ulnar nerve is most vulnerable in Guyon's canal.