Peripheral nerve perfusion by dynamic contrast-enhanced magnetic resonance imaging: demonstration of feasibility

Purpose: The aim of this study was to establish dynamic contrast-enhanced perfusion in peripheral nerves for determination of blood-nerve permeability (Ktrans) and nerve blood volume (NBV) in peripheral neuropathies as compared with healthy controls. Methods: The study was approved by the institutio...

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Hauptverfasser: Bäumer, Philipp (VerfasserIn) , Radbruch, Alexander (VerfasserIn) , Bendszus, Martin (VerfasserIn) , Heiland, Sabine (VerfasserIn) , Pham, Mirko (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: August 2014
In: Investigative radiology
Year: 2014, Jahrgang: 49, Heft: 8, Pages: 518-523
ISSN:1536-0210
DOI:10.1097/RLI.0000000000000046
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/RLI.0000000000000046
Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/investigativeradiology/Fulltext/2014/08000/Peripheral_Nerve_Perfusion_by_Dynamic.3.aspx
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Verfasserangaben:Philipp Bäumer, Maximilian Reimann, Clemens Decker, Alexander Radbruch, Martin Bendszus, Sabine Heiland, and Mirko Pham

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520 |a Purpose: The aim of this study was to establish dynamic contrast-enhanced perfusion in peripheral nerves for determination of blood-nerve permeability (Ktrans) and nerve blood volume (NBV) in peripheral neuropathies as compared with healthy controls. Methods: The study was approved by the institutional ethics committee, and written informed consent was obtained from all participants. Forty-three controls (24 women, 19 men; age, 48.7 ± 17.5 years) and 59 patients with peripheral neuropathy (28 women, 31 men; age, 52.7 ± 12.4 years) were examined by a standard protocol including a T1-weighted dynamic contrast-enhanced sequence (time of repetition/time of echo, 4.91/1.64; 10 slices; resolution 0.8 × 0.6 × 3.0 mm3). Time - signal intensity analysis was performed by normalizing to pre-bolus arrival and calculating the mean contrast uptake (MCU) for each patient. Further analyses were performed by customized software to calculate Ktrans and NBV. Statistical analysis included 2-sided Student’s t tests of controls versus patients, receiver operating characteristic analysis, and subgroup analysis of patients according to etiologies of neuropathy. Results: Time-signal intensity analysis showed significantly increased contrast uptake in patients as compared with controls (MCU, 1.29 ± 0.15 vs 1.18 ± 0.08; P < 0.001). This was caused mainly by an increase in Ktrans (0.046 ± 0.025 vs 0.026 ± 0.016 min−1; P < 0.001) and less by an increase in NBV (3.9 ± 2.6 vs 3.0 ± 1.9 mL/100 mL; P = 0.12). This trend was true for all etiologies except entrapment neuropathies. Excluding these, receiver operating characteristic analysis found an area under the curve of 0.78 (95% confidence interval, 0.69-0.89) for MCU and 0.77 (95% confidence interval, 0.65-0.90) for Ktrans to discriminate neuropathy from control. Conclusions: Dynamic contrast-enhanced perfusion is a feasible technique to assess Ktrans and NBV in peripheral nerves and may be used in future investigations on peripheral neuropathies. 
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