Initial findings in traumatic peripheral nerve injury and repair with diffusion tensor imaging.


Journal

Annals of clinical and translational neurology
ISSN: 2328-9503
Titre abrégé: Ann Clin Transl Neurol
Pays: United States
ID NLM: 101623278

Informations de publication

Date de publication:
02 2021
Historique:
received: 23 07 2020
revised: 19 11 2020
accepted: 19 11 2020
pubmed: 7 1 2021
medline: 3 11 2021
entrez: 6 1 2021
Statut: ppublish

Résumé

Management of peripheral nerve injuries requires physicians to rely on qualitative measures from patient history, electromyography, and physical exam. Determining a successful nerve repair can take months to years for proximal injuries, and the resulting delays in clinical decision-making can lead to a negative impact on patient outcomes. Early identification of a failed nerve repair could prevent permanent muscle atrophy and loss of function. This study aims to test the feasibility of performing diffusion tensor imaging (DTI) to evaluate injury and recovery following repair of wrist trauma. We hypothesize that DTI provides a noninvasive and reliable assessment of regeneration, which may improve clinical decision-making and alter the clinical course of surgical interventions. Clinical and MRI measurements from subjects with traumatic peripheral nerve injury, carpal tunnel syndrome, and healthy control subjects were compared to evaluate the relationship between DTI metrics and injury severity. Fractional anisotropy from DTI was sensitive to differences between damaged and healthy nerves, damaged and compressed nerves, and injured and healthy contralateral nerves. Longitudinal measurements in two injury subjects also related to clinical outcomes. Implications of other diffusion measures are also discussed. DTI is a sensitive tool for wrist nerve injuries and can be utilized for monitoring nerve recovery. Across three subjects with nerve injuries, this study has shown how DTI can detect abnormalities between injured and healthy nerves, measure recovery, and determine if re-operation was successful. Additional comparisons to carpal tunnel syndrome and healthy nerves show that DTI is sensitive to the degree of impairment.

Identifiants

pubmed: 33403827
doi: 10.1002/acn3.51270
pmc: PMC7886047
doi:

Types de publication

Case Reports Journal Article Research Support, N.I.H., Extramural Research Support, U.S. Gov't, Non-P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

332-347

Subventions

Organisme : NIBIB NIH HHS
ID : T32 EB001628
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS097821
Pays : United States
Organisme : U.S. Department of Defense
ID : W81XWH-15-JPC-8/CRMRP-NMSIRA
Organisme : National Institute of Health/National Institute of Neurological Disease and Stroke
ID : R01 NS097821 (RDD)
Organisme : U.S. Department of Defense
ID : MR150075 (WPT)

Informations de copyright

© 2021 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.

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Auteurs

Michael D Pridmore (MD)

Vanderbilt Institute for Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Gabriella E Glassman (GE)

Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Alonda C Pollins (AC)

Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Isaac V Manzanera Esteve (IV)

Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Brian C Drolet (BC)

Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Douglas R Weikert (DR)

Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Mark D Does (MD)

Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.

Galen Perdikis (G)

Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Wesley P Thayer (WP)

Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Richard D Dortch (RD)

Vanderbilt Institute for Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.
Department of Neuroimaging Research, Barrow Neurological Institute, Phoenix, Arizona, USA.

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