Magnetic Resonance Neuroimaging of Peripheral Nerve Pathologies

Magnetic resonance neuroimaging has emerged as a pivotal tool for the non-invasive visualisation and quantification of peripheral nerve structure and pathology. Leveraging high-field magnets, dedicated coils and advanced pulse sequences such as fat-suppressed T2-weighted imaging and three-dimensional acquisitions, clinicians can now depict nerve morphology with sub-millimetre resolution. These techniques facilitate the detection of focal and diffuse lesions arising from trauma, entrapment, inflammatory and hereditary neuropathies. Beyond simple anatomical delineation, quantitative metrics—including signal intensity ratios and diffusion parameters—offer objective biomarkers of axonal integrity, myelin status and disease severity. Collectively, these advances hold promise for improved diagnosis, longitudinal monitoring and tailored therapeutic planning in peripheral nerve disorders worldwide.

Research from Nature Portfolio

Recent studies have demonstrated the capability of a novel three-dimensional sequence to assess traumatic brachial plexus injuries with high diagnostic accuracy. In a cohort of patients with suspected postganglionic lesions, this approach achieved specificity in excess of 90 % and overall accuracy above 80 %, outperforming conventional electrophysiology in certain parameters. The method enabled precise localisation from roots through cords and branches, with surgical and follow-up correlation confirming its reliability. Such work highlights the potential of advanced volumetric neurography to transform preoperative assessment and guide microsurgical strategies in complex peripheral nerve trauma.

Magnetic Resonance Neuroimaging of Peripheral Nerve Pathologies publication trend

The graph below shows the total number of articles in magnetic resonance neuroimaging of peripheral nerve pathologies across all publications each year (not limited to Nature Index journals).

Technical terms

Magnetic Resonance Neurography: High-resolution MRI techniques dedicated to imaging peripheral nerves and their pathological alterations.

3D SHINKEI: A three-dimensional sequence combining high spatial resolution with fat suppression to enhance contrast of nerve structures in MR neurography.

Diffusion Tensor Imaging (DTI): MRI technique that measures directional diffusion of water molecules to assess microstructural integrity of nerve fibres.

Fractional Anisotropy (FA): Quantitative index derived from DTI reflecting the degree of directional water diffusion, commonly used to infer axonal and myelin integrity.

References

1. Accuracy of MR neurography as a diagnostic tool in detecting injuries to the lingual and inferior alveolar nerve in patients with iatrogenic post-traumatic trigeminal neuropathy. European Radiology (2023).
2. 3D SHINKEI MR neurography in evaluation of traumatic brachial plexus. Scientific Reports (2024).
3. High-Resolution 3T MR Neurography of the Brachial Plexus and Its Branches, with Emphasis on 3D Imaging. American Journal of Neuroradiology (2012).
4. Peripheral Nerve Diffusion Tensor Imaging: Assessment of Axon and Myelin Sheath Integrity. PLOS ONE (2015).
5. MR Neurography: Advances. Radiology Research and Practice (2013).