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Denervated human skeletal muscle: MR imaging evaluation

J L Fleckenstein1, D Watumull, K E Conner

  • 1Department of Radiology, Algur H. Meadows Diagnostic Imaging Center, University of Texas, Southwestern Medical Center, Dallas, TX 75235-8896.

Radiology
|April 1, 1993
PubMed
Summary

Magnetic resonance (MR) imaging shows promise for mapping denervated muscles in patients with peripheral neuropathy. While unreliable for acute injuries, MR imaging effectively visualizes subacute and chronic denervation changes in skeletal muscle.

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Area of Science:

  • Neurology
  • Radiology
  • Musculoskeletal Imaging

Background:

  • Assessing neurologic integrity after severe limb trauma is critical for patient management.
  • Traumatic peripheral neuropathy can lead to denervation of skeletal muscle motor units.

Purpose of the Study:

  • To evaluate magnetic resonance (MR) imaging as a tool for mapping denervated motor units in patients with traumatic peripheral neuropathy.
  • To determine the reliability of MR imaging in different phases of denervation.

Main Methods:

  • MR imaging was performed on 22 patients with confirmed denervation (via electromyography, surgery, or both).
  • Utilized moderately T1- and T2-weighted spin-echo and short-tau inversion-recovery (STIR) sequences.

Main Results:

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  • MR imaging was unreliable in depicting acute denervation.
  • Subacute denervation showed prolonged T1 and T2 relaxation times, leading to hyperintensity on STIR images.
  • Chronic denervation exhibited muscle atrophy, variable STIR signal changes, and fatty infiltration on T1-weighted images.

Conclusions:

  • MR imaging is a promising noninvasive tool for mapping and monitoring denervated muscle in the subacute and chronic phases of peripheral neuropathy.
  • Findings can help differentiate between true denervation and normal anatomical variants.