mr neurography in ulnar neuropathy as surrogate parameter for the presence of disseminated neuropathy神经学先生在尺神经病变作为代理参数为弥散性神经病变的存在.pdfVIP

MR Neurography in Ulnar Neuropathy as Surrogate Parameter for the Presence of Disseminated Neuropathy ¨ 1 3 1 4 4 2 Philipp Baumer *, Markus Weiler , Maurice Ruetters , Frank Staub , Thomas Dombert , Sabine Heiland , Martin Bendszus1, Mirko Pham1 1 Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany, 2 Section of Experimental Radiology, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany, 3 Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany, 4 Center for Peripheral Nerve Surgery, Dossenheim-Heidelberg, Germany Abstract Purpose: Patients with ulnar neuropathy of unclear etiology occasionally present with lesion extension from elbow to upper arm level on MRI. This study investigated whether MRI thereby distinguishes multifocal neuropathy from focal-compressive neuropathy at the elbow. Methods: This prospective study was approved by the institutional ethics committee and written informed consent was obtained from all participants. 122 patients with ulnar mononeuropathy of undetermined localization and etiology by clinical and electrophysiological examination were assessed by MRI at upper arm and elbow level using T2-weighted fat- saturated sequences at 3T. Twenty-one patients were identified with proximal ulnar nerve lesions and evaluated for findings suggestive of disseminated neuropathy (i) subclinical lesions in other nerves, (ii) unfavorable outcome after previous decompressive elbow surgery, and (iii) subsequent diagnosis of inflammatory or other disseminated neuropathy. Two groups served as controls for quantitative analysis of nerve-to-muscle signal intensity ratios: 20 subjects with typica