There is a short
open-access article about whole-body neuronal MRI, in the most recent
NEJM. The authors describe a technique of visualizing peripheral
nerves. Normally, these are not seen very well on MRI. This
limits the usefulness of MR imaging for nerves outside of the central
nervous system.
The two images on the left are from a person with no neurological
disease. The two on the right show a person with
href="http://scienceblogs.com/effectmeasure/2008/04/disease_at_the_head_table_seco.php">chronic
inflammatory demyelinating polyneuropathy (CIDP). You can see
a bigger version by clicking through to the journal article, although
you probably won't be able to see a lot more detail. (It is a
larger fuzzy picture, instead of a smaller fuzzy picture.)
href="http://content.nejm.org/cgi/content/full/361/5/538">Whole-Body
Magnetic Resonance Neurography
Tomohiro Yamashita, M.D.
Thomas C. Kwee, M.D.
Taro Takahara, M.D., Ph.D.
To the Editor: Noninvasive selective visualization
of the whole peripheral nervous system may be useful but has not been
possible. Although the brain and spinal cord are well visualized with
magnetic resonance (MR) imaging, peripheral nerves cannot be
selectively visualized by commonly used methods, such as T1-weighted
and (fat-suppressed) T2-weighted imaging, because of the similarity in
signal intensities between the peripheral nerves and surrounding
structures on these images. This report describes an MR-based approach
that is capable of selectively visualizing the peripheral nervous
system over long trajectories in a single examination: whole-body MR
neurography...The applied whole-body MR neurography technique is based
on the recently developed concept of diffusion-weighted whole-body
imaging with background body signal suppression (DWIBS)...
Folks have been working on this for a long time. See Imaging of the
peripheral nervous system: evaluation of peripheral neuropathy and
plexopathy for a review from eleven years ago, discussing the
challenges of MRI for the peripheral nervous system (PNS). You
have to go here,
then download the PDF to read the article.)
In the interim, advances have been made in using neuroimaging for the
PNS in specific locations. See examples
href="http://www.thecni.org/reviews/13-2-p18-solsberg.htm">here.
Now, it is possible to visualize the entire PNS in one scan, albeit
without a great resolution.
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Can you tell us the most likely uses for this technology. For instance, would it be useful in tracking the progression of diseases like MS?
Routine brain MRI is already pretty good for tracking MS. Personally, I do not see whole-body neurography as something that is likely to be widely applicable. However, for many new techniques, the applications are not immediately obvious. It will take additional research to figure out what this is good for.
There might not be specific uses for whole body neurography, but the methods used to do this can probably get even better quality pictures of local regions. There are currently various pain related diseases like sciatica where many people bounce between unsuccessful treatments. If this could better separate different types of nerve problems and improve treatment plans, that would be huge.