[Choosing the right imaging for the diagnostics and assessment of the course of peripheral nerve injuries].

Die Wahl der richtigen Bildgebung zur Diagnostik und Verlaufsbeurteilung peripherer Nervenverletzungen.

Publisher: Springer Verlag Country of Publication: Germany NLM ID: 0400773 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-0407 (Electronic) Linking ISSN: 00282804 NLM ISO Abbreviation: Nervenarzt Subsets: MEDLINE

Original Publication: Berlin : Springer Verlag

Peripheral Nerve Injuries*/diagnostic imaging; Humans ; Magnetic Resonance Imaging/methods ; Ultrasonography ; Syndrome

Background: Nerve injuries are a frequent problem in routine clinical practice and require intensive interdisciplinary care.
Objective: The current status of imaging to confirm the diagnosis of nerve injuries is described. The role of high-resolution ultrasound and magnetic resonance imaging (MRI) in the diagnostics and follow-up of peripheral nerve injuries is elaborated.
Material and Methods: Review of the current state of imaging to confirm the diagnosis of nerve injuries.
Results: Depending on the suspected site of damage, the primary domain of magnetic resonance (MR) imaging (MR neurography) is injuries in the region of the spine, nerve roots, brachial plexus and lumbar plexus, pelvis and proximal thigh. In contrast, in other peripheral nerve lesions of the extremities the advantages of high-resolution nerve ultrasound in a dynamic setting predominate. The MR neurography is indicated here, especially in the frequent bottleneck syndromes and only in very isolated and selected cases.
Conclusion: In addition to a correct anatomical assignment, the timely decision for a possible intervention and the appropriate concomitant treatment are an important basis for a favorable prognosis of nerve injuries. Imaging techniques should therefore be used early in the diagnostics and follow-up controls of peripheral nerve injuries.
(© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

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Keywords: Brachial plexus; Lumbar plexus; Magnetic resonance imaging/nerves; Peripheral nerves; Ultrasonography/nerves
Local Abstract: [Publisher, German] HINTERGRUND: Nervenverletzungen sind ein häufiges Problem im klinischen Alltag und erfordern eine intensive interdisziplinäre Betreuung. [Publisher, German] Der aktuelle Stand der Bildgebung zur Diagnosesicherung von Nervenverletzungen wird beschrieben. Dabei wird auf die Rolle des hochauflösenden Ultraschalls und der Magnetresonanztomographie in der Diagnostik und Nachsorge peripherer Nervenverletzungen eingegangen. [Publisher, German] Übersicht des aktuellen Stands der Bildgebung zur Diagnosesicherung von Nervenverletzungen. [Publisher, German] Abhängig vom vermuteten Schädigungsort sind die primäre Domäne der magnetresonanztomographischen (MR) Bildgebung (MR-Neurographie) Verletzungen im Bereich der Wirbelsäule, der Nervenwurzeln, des Plexus brachialis und lumbalis sowie des Beckens und proximalen Oberschenkels. Bei weiter peripher gelegenen Nervenläsionen der Extremitäten überwiegen dagegen die Vorteile des hochauflösenden Nervenultraschalls in einem dynamischen Setting. Die MR-Neurographie ist hier, insbesondere bei den häufigen Engpasssyndromen, nur in sehr vereinzelten und ausgewählten Fällen indiziert. [Publisher, German] Für eine günstige Prognose von Nervenverletzungen sind neben einer korrekten anatomischen Zuordnung die rechtzeitige Entscheidung für einen möglichen Eingriff und die geeignete Begleittherapie eine wichtige Grundlage. Bildgebende Verfahren sollten daher früh in der Diagnostik und den Verlaufskontrollen peripherer Nervenverletzungen eingesetzt werden.

Date Created: 20231017 Date Completed: 20231129 Latest Revision: 20231129

20231215

10.1007/s00115-023-01550-z

37848647