Neurogene Myopathien und Bildgebung der Muskeldenervation

Clinical issueNeurogenic myopathies are primary diseases of the nervous system, which secondarily result in denervation of the target musculature. The spectrum of potential causes is manifold ranging from acute traumatic injuries and chronic compression to neurodegenerative, inflammatory, metabolic...

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Hauptverfasser: Wolf, Marcel (VerfasserIn) , Wolf, Christian (VerfasserIn) , Weber, Marc-André (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Deutsch
Veröffentlicht: 17. Oktober 2017
In: Der Radiologe
Year: 2017, Jahrgang: 57, Heft: 12, Pages: 1038-1051
ISSN:1432-2102
DOI:10.1007/s00117-017-0316-x
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1007/s00117-017-0316-x
Verlag, Volltext: https://doi.org/10.1007/s00117-017-0316-x
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Verfasserangaben:M. Wolf, C. Wolf, M.‑A. Weber

MARC

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520 |a Clinical issueNeurogenic myopathies are primary diseases of the nervous system, which secondarily result in denervation of the target musculature. The spectrum of potential causes is manifold ranging from acute traumatic injuries and chronic compression to neurodegenerative, inflammatory, metabolic and neoplastic processes.Standard diagnostic methodsThe medical history, clinical neurological examination, and electrophysiological tests including electromyography and nerve conduction studies are crucial in diagnosing neuropathic myopathies. Electromyography is the gold standard for diagnosing muscle denervation.Methodical innovationsAdditional imaging methods and magnetic resonance imaging (MRI) in particular, are capable of contributing valuable information. The MRI examination of denervated musculature shows edema, an increase in the apparent diffusion coefficient (ADC) and hyperperfusion. Chronic denervation results in fatty degeneration and atrophy of affected muscles, which are also detectable by MRI.PerformanceAlthough the MRI findings in muscle denervation are relatively unspecific, they show a high sensitivity, comparable to electromyography. Dedicated MR neurography may often visualize the underlying lesion(s) of the innervating nerve(s).AchievementsBesides high sensitivity, comparable to electromyography, MRI is capable of evaluating muscles which are inaccessible for needle electromyography. Due to its non-invasive character, MRI is ideal for follow-up examinations.Practical recommendationsThe use of MRI is often a meaningful addition to the diagnostics of neurogenic myopathies. The extent and distribution pattern of muscular alterations often provide information on the localization of the causative nerve damage. A correct diagnosis or at least a narrowing down of possible differential diagnoses can often be achieved using MRI. 
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650 4 |a Peripheral nerves 
650 4 |a Periphere Nerven 
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