Postoperative Imaging Characteristics of Targeted Muscle Reinnervation and Regenerative Peripheral Nerve Interfaces

Area of Science:

• Medical Imaging
• Regenerative Medicine
• Surgical Innovation

Background:

• Neuromas can still form after targeted muscle reinnervation (TMR) and regenerative peripheral nerve interface (RPNI) procedures.
• Post-operative soft tissue changes around nerve constructs present diagnostic challenges.
• Understanding imaging characteristics is crucial for accurate diagnosis.

Purpose of the Study:

• To review and synthesize existing literature on the ultrasound (US) and magnetic resonance imaging (MRI) characteristics of TMR and RPNI.
• To aid clinicians in identifying TMR and RPNI on imaging.
• To assist in the diagnosis of soft tissue lesions in post-amputation patients.

Main Methods:

• A systematic literature review was conducted using major scientific databases (PubMed, Embase, Cochrane, Web of Science).
• Studies describing imaging characteristics of TMR and RPNI in humans were included.
• Screening and selection followed PRISMA 2020 guidelines.

Main Results:

• The review identified 4 eligible studies out of 623 initially screened articles.
• One study described US for TMR; two studies described US for RPNI.
• One study described MRI for RPNI, involving a total of 44 patients, 70 RPNIs, and 6 TMRs.

Conclusions:

• Characterization of TMR and RPNI on US and MRI is currently limited, especially for upper extremity procedures.
• TMR and RPNI exhibit consistent core imaging features on US and MRI.
• Awareness of expected imaging changes is vital for plastic surgeons managing post-amputation pain and soft tissue lesions.