• MeSH
• Lower Extremity diagnostic imaging   pathology   MeSH
• Edema etiology   physiopathology   MeSH
• Humans MeSH
• Magnetic Resonance Imaging * methods   MeSH
• Neuromuscular Diseases * diagnostic imaging   MeSH
• Peripheral Nerves diagnostic imaging   pathology   MeSH
• Muscles diagnostic imaging   pathology   MeSH
• Check Tag
• Humans MeSH

BACKGROUND: Diverse adipose lesions can affect peripheral nerves, including an intrinsic disorder known as lipomatosis of nerve (LN). This condition leads to massive nerve enlargement and has often been associated with nerve territory overgrowth. Although LN has been well documented as a peripheral lesion, it is uncertain whether LN can occur or extend intradurally. METHODS: In the present 2-part study, we searched our institutional database and the world literature to identify any case of LN occurring or extending intradurally. Strict pathognomonic imaging and histopathologic features of LN were required to be present. RESULTS: We did not identify any case of LN that had occurred or extended intradurally in our institution. Specifically, in our database, we found no case of intradural LN, and an evaluation of the imaging studies of proximal examples of LN did not show any extension proximal to the spinal foramen. Our literature search identified 208 reports of potential interest, of which only 3 had reported on spinal LN. Although 2 of the 3 cases showed some similarities to LN, none had demonstrated features diagnostic for LN and none had demonstrated nerve territory overgrowth. A review of 16 cases of LN in proximal locations summarized in a recently reported systematic review did not reveal any cases with LN proximal to the foramen or in an intradural location. CONCLUSION: A review of our institutional cases and reported cases did not show any example of LN extending or occurring intradurally. It appears that LN is a benign tumor-like nerve lesion that is without a central location, unlike more well-known tumors such as schwannomas.

• MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Lipomatosis diagnostic imaging   pathology   MeSH
• Magnetic Resonance Imaging MeSH
• Young Adult MeSH
• Peripheral Nerves diagnostic imaging   pathology   MeSH
• Retrospective Studies MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

The general microscopic characteristics of nerves are described in several textbooks of histology, but the specific microanatomies of most nerves that can be blocked by anesthesiologists are usually less well known. Our objective was to evaluate the 3D reconstruction of nerve fascicles from optical projection tomography images (OPT) and the ability to undertake an internal navigation exploring the morphology in detail, more specifically the fascicular interconnections. Median and lingual nerve samples were obtained from five euthanized piglets. OPT images of the samples were acquired and 3D reconstruction was performed. The OPT technique revealed the inner structure of the nerves at high resolution, including large and small fascicles, perineurium, interfascicular tissue, and epineurium. The fascicles were loosely packed inside the median nerve and more densely so in the lingual nerve. Analysis of the 3D models demonstrated that the nerve fascicles can show six general spatial patterns. Fascicular interconnections were clearly identified. The 3D reconstruction of nerve fascicles from OPT images opens a new path for research into the microstructure of the inner contents of fascicular nerve groups and their spatial disposition within the nerve including their interconnections. These techniques enable 3D images of partial areas of nerves to be produced and could became an excellent tool for obtaining data concerning the 3D microanatomy of nerves, essential for better interpretation of ultrasound images in clinical practice and thus avoiding possible neurological complications. Clin. Anat. 31:424-431, 2018. © 2017 Wiley Periodicals, Inc.

• MeSH
• Humans MeSH
• Tomography, Optical MeSH
• Peripheral Nerves diagnostic imaging   MeSH
• Imaging, Three-Dimensional methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Evaluation Study MeSH

Cíl: Vyvinout vyšetřovací protokol umožňující zobrazení funkční integrity a mikrostrukturálního postižení periferních nervů (PN) v různých lokalitách pomocí difuzního tenzoru (DTI). Následně implementovat vyšetřovací protokol do klinické praxe. Soubor a metodika: Vyšetřili jsme 15 zdravých dobrovolníků a 15 pacientů na 3T MR přístroji pomocí metody DTI. Snažili jsme se zobrazit brachiální plexus, lumbosakrální plexus a průběh PN na končetinách u zdravých dobrovolníků. U pacientů jsme cílili vyšetření na postižené úseky PN za účelem zobrazit tyto patologie. Výsledky: Podařilo se nám získat validní zobrazení brachiálního i lumbosakrálního plexu a průběhu PN na končetinách pomocí DTI. Setkali jsme se s některými limitacemi metody, zejména pohybovými artefakty, narušujícími kvalitní zobrazení nervových struktur, a problémy s odlišením nervových vláken od vláken svalových. Tyto technické problémy mohou být do určité míry eliminovány využitím adekvátních cívek, optimalizací zobrazovacích protokolů a metodikou následného zpracování dat. Závěr: Přes některé technické limitace práce demonstruje možnost získat validní zobrazení PN v různých lokalitách prostřednictvím metody DTI. DTI představuje doplňkovou neinvazivní zobrazovací techniku poskytující cenné informace využitelné v rozhodovacím diagnostickém a léčebném procesu u nejrůznějších patologií PN. Technologický pokrok a další zdokonalování metod MR v budoucnu pravděpodobně povede k rozšíření a širšímu uplatnění této techniky v klinické praxi.

Aim: Development of an examination protocol for investigation of functional integrity and microstructural damage of peripheral nerves (PN) at different locations using diffusion tensor imaging (DTI). Consequently, we want to implement this protocol into clinical practice. Subjects and methods: We investigated 15 healthy volunteers and 15 patients with a 3T MRI, scanner using the DTI method. We attempted to visualize the brachial plexus, lumbosacral plexus and the course of PN in the limbs of healthy volunteers. In patients, we focused on the examination of damaged parts of the PN to display these pathologies. Results: We managed to obtain a valid visualization of the brachial plexus, lumbosacral plexus and the course of PN in the limbs using DTI. Throughout the study, we encountered some limitations of this method, particularly motion artifacts which interfered with the quality of nerve structure imaging and problems in differentiating nerve fibers from muscle fibers. These technical problems could be reduced to a certain extent using adequate coils, optimizing imaging protocols and data procesing methodology. Conclusion: Despite some technical limitations, this paper demonstrates the possibility of obtaining a valid display of PN in different locations using the DTI method. DTI is an additional non-invasive imaging technique providing valuable information useful in the decision-making diagnostic and therapeutic process for various PN pathologies. Technological advances and further improvements of MRI techniques in the future are likely to result in a wider use of this technique in clinical practice.

• MeSH
• Adult MeSH
• Clinical Studies as Topic MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging * methods   MeSH
• Young Adult MeSH
• Peripheral Nerves * diagnostic imaging   MeSH
• Brachial Plexus diagnostic imaging   MeSH
• Lumbosacral Plexus diagnostic imaging   MeSH
• Diffusion Tensor Imaging * methods   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

Muskuloskeletální (MSK) ultrazvuk slouží k zobrazení struktur muskuloskeletálního systému – svalů, šlach, kloubů, kostí, periferních nervů a cév. V posledních dvou dekádách roste množství publikací a studií, prokazujících využitelnost ultrazvuku v diagnostice různých neurologických chorob. Neméně důležitou oblastí, kde lze MSK ultrazvukovou diagnostiku uplatnit jsou intervenční výkony v neurologii – obstřiky periferních nervů, lokální nervové blokády, punkce cév, lumbální punkce, svalové biopsie. Ultrazvukové vyšetření je rychlou, široce dostupnou, relativně levnou, neinvazivní a pro pacienta pohodlnou vyšetřovací metodou použitelnou při diagnostice a diferenciální diagnostice muskuloskeletálního aparátu včetně periferních nervů. Navíc umožňuje také dynamické vyšetření tkání. Je to vhodná diagnostická metoda první volby.

Musculoskeletal (MSK) ultrasound is used to visualize the structures of the musculoskeletal system, i.e. muscles, tendons, joints,bones, peripheral nerves, and vessels. In the last two decades, there have been a growing number of publications and studiesdemonstrating the applicability of ultrasound in diagnosing various neurological diseases. An equally important field where MSKultrasound diagnosis can be utilized is interventional neurology procedures – local peripheral nerve anaesthesia, local nerve blocks,vessel puncture, lumbar puncture, and muscle biopsy. Ultrasonography is a rapid, widely available, relatively inexpensive, non-invasive,and patient-comfortable method used in the diagnosis and differential diagnosis of the musculoskeletal system includingthe peripheral nerves. In addition, it allows dynamic examination of the tissues. It is a suitable diagnostic method of first choice.

• MeSH
• Ultrasonography, Doppler, Duplex * MeSH
• Ultrasonography, Interventional MeSH
• Skeleton diagnostic imaging   pathology   MeSH
• Humans MeSH
• Musculoskeletal Diseases diagnosis   MeSH
• Musculoskeletal System * diagnostic imaging   MeSH
• Peripheral Nerves * diagnostic imaging   MeSH
• Tendons diagnostic imaging   pathology   MeSH
• Muscles diagnostic imaging   pathology   MeSH
• Ultrasonography MeSH
• Check Tag
• Humans MeSH

MR traktografie (MRT) se stala v posledních letech velmi důležitou a neinvazivní metodou zobrazení svazků bílé hmoty a periferních nervů měřením difúze molekul vody magnetickou rezonancí. Zde je uveden krátký historický vývoj a implementace MRT do klinické praxe na našem pracovišti IKEM. Dále je uveden stručný přehled některých aplikací MRT mozku a 3D MR neurografíe (MRN) periferních nervů. Obě metody mohou hrát důležitou roli při plánování neurochirurgických operací a sledování postoperačních změn mozkových a periferních nervových mikrostruktur.

MR tractography (MRT) has become an important method for noninvasive visualization of white matter bundles and peripheral nerves using magnetic resonance imaging measurment of water molecule diffusion. This paper gives a short historical overview and implementation of the MRT into clinical practice in the institute IKEM. Furthermore, the paper gives a short overview of some MRT applications of brain and 3D MR neurography of peripheral nerves. The MR tractography and MR neurography may be used in the presurgical planning and post-operative follow-up of the brain and peripheral nerves microstructural changes.

• MeSH
• Humans MeSH
• Magnetic Resonance Imaging * methods   MeSH
• Brain * diagnostic imaging   MeSH
• Neuroimaging methods   MeSH
• Peripheral Nerves * diagnostic imaging   MeSH
• Diffusion Tensor Imaging * methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH