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Case Reports
. 2020 Apr;61(4):521-526.
doi: 10.1002/mus.26800. Epub 2020 Jan 22.

7T MR neurography-ultrasound fusion for peripheral nerve imaging

Stefanie Schreiber  1   2   3 , Frank Schreiber  1   2 , Alica Peter  1 , Eser Isler  1   2 , Marc Dörner  4 , Hans-Jochen Heinze  1   2   3   5 , Suanne Petri  6 , Claus Tempelmann  1 , Peter J Nestor  7   8 , Alexander Grimm  9 , Stefan Vielhaber  1   2   3
Affiliations
Case Reports

7T MR neurography-ultrasound fusion for peripheral nerve imaging

Stefanie Schreiber et al. Muscle Nerve. 2020 Apr.

Abstract

Background: We present one patient with an initial diagnosis of Guillain-Barré syndrome (GBS) and one with Charcot-Marie-Tooth disease (CMT) type 1A.

Methods: Both patients underwent ankle tibial nerve fusion-imaging of high-resolution ultrasound (HRUS) with 7T MR neurography (MRN).

Results: In GBS, the nerve was enlarged, T2-hyperintense, and showed increased vascularization 21 months after symptom onset. In CMT1A, the enlarged nerve was T2-isointense with normal endoneurial blood flow.

Conclusions: We demonstrate the utility of 7T-MRN-HRUS-fusion-imaging. In GBS, there was evidence of ongoing inflammation resulting in a changed diagnosis to acute-onset chronic demyelinating polyradiculoneuropathy and maintenance of immunotherapy. By MRN-HRUS-fusion, patients with presumed peripheral axonal degeneration could be shown to display imaging markers associated with peripheral nervous system inflammation. Thus, more accurate identification of a treatable inflammatory component may become possible.

Keywords: CMT1A; fusion imaging; magnetic resonance neurography; microvascular blood flow; ultrasound.

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References

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