Applicability of Magnetic Resonance Imaging for Early Diagnosis of Common Peroneal Neuropathy

Gwang Yoon Choi, Jinseo Yang, Y. Cho, H. Choi, Jinpyeong Jeon, S. Kang
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Abstract

Objective: This study aimed to assess the clinical applicability of magnetic resonance imaging (MRI) for the early diagnosis of common peroneal neuropathy (CPNe).Methods: Over three years, the authors have treated 58 patients with CPNe. All patients had clinical or neurophysiological confirmation of CPNe. Among them, 35 (60%) patients underwent axial knee MRI with a 1.5-Tesla scanner. These 35 patients were selected for study and were classified into three groups according to the time of examination after the occurrence of dropped foot―acute, subacute, and chronic onset groups. According to muscle appearances (normal, edematous change, and atrophy), we diagnosed them with CPNe, except for those with normal morphology. We evaluated the applicability of MRI in the diagnosis of CPNe compared to that of electromyography (EMG).Results: The 18, 11, and six cases were included in the acute, subacute, and chronic onset groups, respectively. In the acute onset group, three cases had normal muscle appearance, while 15 cases had edematous changes in the affected muscles. In the subacute onset group, eight cases had edematous changes, while three cases showed muscle atrophy. In the chronic onset group, six cases had muscle atrophy. CPNe could be diagnosed using MRI in about 91% (32/35) of all the cases. Excluding the chronologically chronic stage, diagnosis rate was approximately 89%(26/29) of all the cases. However, only in 27 cases (77%) denervation potentials were presented on EMG.Conclusion: According to our results, MRI is a helpful diagnostic modality, especially in the early stage of CPNe, and may lead to proper management.
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磁共振成像在腓总神经病变早期诊断中的适用性
目的:探讨磁共振成像(MRI)在腓总神经病变(CPNe)早期诊断中的临床应用价值。方法:作者在3年多的时间里治疗了58例CPNe患者。所有患者均经临床或神经生理学证实为CPNe。其中35例(60%)患者采用1.5-Tesla扫描仪行轴向膝关节MRI。选取35例患者作为研究对象,根据下垂足发生后检查时间将其分为急性、亚急性和慢性起病组。根据肌肉外观(正常、水肿改变、萎缩),除形态正常者外,我们诊断为CPNe。我们评估了MRI与肌电图(EMG)诊断CPNe的适用性。结果:急性组18例,亚急性组11例,慢性组6例。急性发作组3例肌肉外观正常,15例受累肌肉出现水肿改变。亚急性发作组8例出现水肿改变,3例出现肌肉萎缩。慢性发病组有6例出现肌肉萎缩。MRI诊断CPNe的病例约占91%(32/35)。排除慢性分期,所有病例的诊断率约为89%(26/29)。然而,只有27例(77%)在肌电图上显示去神经支配电位。结论:根据我们的研究结果,MRI是一种有用的诊断方式,特别是在CPNe的早期,并可能导致适当的处理。
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