Simultaneous MR neurography and apparent T2 mapping of cervical nerve roots before microendoscopic surgery to treat patient with radiculopathy due to cervical disc herniation: Preliminary results. (April 2020)

• Record Type: Journal Article
• Authors: Eguchi, Yawara; Enomoto, Keigo; Sato, Takashi; Watanabe, Atsuya; Sakai, Takayuki; Norimoto, Masaki; Yoneyama, Masami; Aoki, Yasuchika; Suzuki, Munetaka; Yamanaka, Hajime; Tamai, Hiroshi; Kobayashi, Tatsuya; Orita, Sumihisa; Suzuki, Miyako; Inage, Kazuhide; Shiga, Yasuhiro; Hirosawa, Naoya; Inoue, Masahiro; Koda, Masao; Furuya, Takeo; Nakamura, Junichi; Hagiwara, Shigeo; Akazawa, Tsutomu; Takahashi, Hiroshi; Takahashi, Kazuhisa; Ohtori, Seiji
• Is Part Of: Journal of clinical neuroscience. Volume 74(2020)
• Page Start: 213
• Page End: 219
• Publication Date: 2020-04
• Subjects: iMSDE improved motion sensitized driven equilibrium -- MRI magnetic resonance imaging -- ROI region-of-interest -- SHINKEI nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation imaging -- VAS visual analogue scale -- JOA score Japanese Orthopedic Association score -- DRG dorsal root ganglia -- DTI diffusion tensor imaging; Cervical radiculopathy -- Cervical disc hernia -- Magnetic resonance imaging -- Neurography -- T2 mapping -- Endoscopic surgery; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2019.08.099
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: We evaluated an injured nerve root quantitatively using simultaneous apparent T2 mapping and neurography with SHINKEI-Quant technique before microendoscopic surgery to treat a patient with cervical radiculopathy due to a cervical intervertebral disc herniation. Neurography revealed swelling of the injured nerve, and a longer T2 relaxation time than that for the unaffected contralateral nerve. SHINKEI-Quant is useful for quantitative evaluation of cervical radiculopathy. Abstract: There is no imaging modality to quantitatively evaluate compressed cervical nerve roots in cervical radiculopathy. Here we sought to evaluate the usefulness of simultaneous apparent T2 mapping and neurography with nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation-enhancement imaging (SHINKEI-Quant) to evaluate compressed nerves quantitatively in patients with cervical radiculopathy due to cervical disc hernia before microendoscopic surgery. One patient with cervical radiculopathy due to cervical disc hernia before microendoscopic surgery and 5 healthy subjects underwent simultaneous apparent T2 mapping and neurography with SHINKEI-Quant. The patient was a 49-year-old man with severe right upper arm pain and numbness. Based on MRI images, we suspected right C7 radiculopathy due to C6-7 cervical disc hernia. The T2 relaxation times of the cervical dorsal root ganglia of the brachial plexus bilaterally at C5–C8 were measured. We observed no significant differences in T2 relaxation times between the nerve roots on the left and right at each spinal level with values in healthy subjects. In our patient, neurography revealed swelling of the right C7 nerve, and a prolonged T2 relaxation time compared with that of the contralateral, unaffected C7 nerve. We performed microendoscopic surgery and the symptoms improved. We were able to evaluate the injured nerve root quantitatively in a patient with cervical radiculopathy using the SHINKEI-Quant technique, being the first study to our knowledge to show the usefulness of this technique to evaluate cervical radiculopathy quantitatively before microendoscopic surgery.