February 9, 2021

Imaging guidance for nerve repair

A noninvasive, quantitative MRI method could be used after surgical repair of traumatic peripheral nerve injury to help clinicians make decisions about whether additional surgical interventions are needed.

After surgical repair of a traumatic peripheral nerve injury, clinicians have limited diagnostic tools to evaluate nerve regeneration and make decisions about whether additional surgical interventions are needed. 

Richard Dortch, PhD, Wesley Thayer, MD, PhD, and colleagues tested the feasibility of using diffusion tensor imaging (DTI) — a noninvasive, quantitative MRI method — to evaluate injury and recovery following repair of wrist trauma in human patients. They compared clinical and DTI metrics from subjects with traumatic peripheral nerve injury, carpal tunnel syndrome and healthy controls. 

The researchers reported in the Annals of Clinical and Translational Neurology that DTI metrics showed differences between damaged and healthy nerves, and that the metrics were sensitive to the degree of impairment. DTI measurements were also related to clinical outcomes following failed repairs and surgical revisions. 

The findings suggest that DTI could be used to detect nerve regeneration failure earlier — perhaps in time for revisional surgery to prevent permanent muscle atrophy and loss of function.

This research was supported by grants from the National Institutes of Health (NS097829) and Department of Defense.