Magnetic resonance imaging neurographies have now become one of the most recommended diagnostic imaging methods for the detection of peripheral neuropathies.
It is estimated that peripheral nerve pathologies affect around 5% of the world’s population, increasing the prevalence in people over 40 years of age. The symptoms can be sensory, motor or mixed, leading to an increase in mortality rates from this condition.
The interpretation of neurography results requires extensive knowledge in MRIs, as well as a complete understanding of the neuromuscular system and the various injuries/neuropathies that can affect it.
At the Panama Clinic Orthopedic Center (COPAC) we offer you a first-class medical service. Only here can you find true experts in the performance and interpretation of neurographies in Panama.
Neurography is a novel high-resolution imaging test for diagnostic purposes (which does not use X-rays), which allows the morphological, functional and quantitative study of peripheral nerves. The various peripheral pathologies can be classified into two types: mononeuropathies and polyneuropathies.
In mononeuropathies we find inflammatory processes, entrapment of vascular or nerve structures, trauma, tumors in the neural sheath (benign or malignant) and other tumors in nearby elements that can compress or break into the plexus or nerves.
On the other hand, polyneuropathies include hereditary and/or acquired pathologies that involve several nerves at the same time, including: Charcot-Marie-Tooth disease, Guillain-Barré syndrome, vasculitis, among others.
It is a non-invasive study that helps to determine the exact location and extent of the pathology, qualify its severity and discover the possible cause of its appearance. Neurography involves the use of advanced 3-tesla MRI equipment, which provides digitized images of nerve structures.
In the procedure, you are given dyes that pass through blood vessels to improve visualization of the fascicular structure of peripheral nerve trunks and perineural tissues; Subsequently, specific functional sequences are applied to clearly identify the characteristics of the neuropathy.
Timely diagnostic imaging is essential to achieve a favorable outcome of peripheral neuropathies. At COPAC, we act quickly to find out what type of neuropathy is affecting your health.
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On the day of your MRI scan, be sure to:
Eat a light meal 2 hours before the test (at most).
Hydrate moderately.
Urinate before entering the MRI room.
Stay calm and relaxed.
Wear comfortable clothes.
Do not wear any type of accessory or costume jewelry.
Obey the instructions of the health personnel.
There are different types of magnetic resonance neurography, among the most common techniques we can mention:
It is the most common type of magnetic resonance neurography. It uses T1 and T2-weighted image sequences to visualize peripheral nerves and related nerve structures.
This technique uses diffusion-weighted imaging to assess the mobility of water in tissues. It allows for better visualization of nerves and can help identify areas of compression or injury.
This technique uses image sequences that suppress the signal from surrounding fatty tissues, making it easier to visualize the nerves and improving the resolution of the images.
In some cases, an intravenous contrast agent may be given to improve visualization of the nerves and detect possible abnormalities or injuries.
Magnetic resonance neurograms (MRN) offer several benefits in the diagnosis and evaluation of neurological conditions. Here are some of the most prominent benefits:
Detailed visualization of nerves: NRM allows detailed images of peripheral nerves and related nerve structures to be obtained. This makes it easier to detect potential injuries, compressions, or nerve abnormalities, which can aid in the diagnosis and treatment of various neurological conditions.
Non-invasive and without ionizing radiation: Unlike other imaging techniques such as electromyography (EMG) or computed tomography (CT), NRM is noninvasive and does not use ionizing radiation. This makes it a safe choice for evaluating peripheral nerves.
Evaluate the structure and morphology of the nerves: NRM not only allows you to visualize the nerves, but also to evaluate their structure and morphology. This can help identify alterations in the shape of the nerves, such as thickening, compression, or injury.
Treatment planning: NRM can be useful in planning interventional or surgical treatments, by providing detailed information about the location and extent of nerve injuries, helping clinicians make more accurate decisions about appropriate treatment.
Neuropathies and tumors evaluation: NRM can be especially useful in the evaluation of peripheral neuropathies, diabetic neuropathies, compression neuropathies, as well as in the detection of tumors or peripheral nerve lesions.
MRI machines usually consist of a sliding table where the patient lies down, surrounded by a powerful magnet. During the procedure, the patient must remain still inside the magnet while the images are acquired. Special antennas or coils are also used to pick up MRI signals and generate the images.
Risk factors in a neurography can vary depending on the specific context and the reason the test is performed. However, some of the risk factors associated with neurography are:
Medical contraindications: Some medical conditions or implanted devices may pose a risk to performing a neurography. For example, people with cardiac pacemakers or metal implants may not be suitable candidates for this type of examination due to the interaction with the magnetic field.
Allergies or sensitivity to contrasts: In some cases, a contrast agent may be used during neurography to improve visualization of the nerves. People who have known allergies to contrasts or who are sensitive to them may be at higher risk for adverse reactions.
Pregnancy: Although there is no conclusive evidence on the adverse effects of MRI on the fetus, some medical centers may avoid performing neurograms in pregnant women, especially during the first trimester.
Anxiety or claustrophobia: The neurography is done in a tight, enclosed space inside the MRI machine. People with anxiety or claustrophobia may experience discomfort or difficulty tolerating the procedure.
Generally, neurography for diagnostic purposes lasts approximately 30 minutes. However, slightly more complex cases that require provocation tests can take up to 45 minutes.
One of the advantages of neurography is that the images can be appreciated from the first moment. However, the study involves a specialized medical interpretation, which must be reflected in a written report attaching the images obtained.
The results of the study are essential to evaluate the anatomical and morphological structures and nerve signals of both the peripheral nerves and the brachial plexus, lumbosacral plexus, perineural tissues and the innervation of these on the muscles.
As mentioned above, neurography is performed using a machine for magnetic resonance imaging, this being a totally painless equipment. However, the patient may perceive momentary pain when receiving the contrast injection minutes before starting the test.
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