正中神经和尺神经的三维筋膜重建:高分辨率超声和磁共振显微镜的初步经验和比较。

IF 3.7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING European Radiology Experimental Pub Date : 2024-08-28 DOI:10.1186/s41747-024-00495-5
Luka Pušnik, Lisa Lechner, Igor Serša, Erika Cvetko, Philipp Haas, Suren Armeni Jengojan, Žiga Snoj
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引用次数: 0

摘要

背景:传统上通过组织学显微切片来研究周围神经的复杂解剖结构,但这种方法存在固有的局限性。我们旨在比较通过断层高分辨率超声(HRUS)和磁共振显微镜(MRM)获得的正中神经和尺神经的三维(3D)重建,并评估它们描述神经内解剖结构的能力:方法:将三个新鲜冷冻的人体上肢标本浸没在水介质中,以准备进行 HRUS 成像。正中神经和尺神经用缝线穿孔,以改善成像时的定向。使用配备了断层三维 HRUS 系统的宽带线性探针(10-22 MHz)对中上臂进行外周神经三维 HRUS 扫描。切除后,神经被切成 16 毫米的小段,并装入 9.4-T 系统的 MRM 探头(扫描时间为 27 小时)。对神经束和神经进行计数,以估算神经体积、神经束体积、神经束数量和束间连接数量。HRUS 重建采用基于人工智能的算法,而 MRM 重建则使用开源成像软件 3D slicer 生成:结果:与 MRM 相比,三维 HRUS 对神经体积的低估高达 22%,对所有筋膜体积的低估高达 11%。此外,与 MRM 相比,三维 HRUS 显示的筋膜数量减少了 6-60%,可视筋膜间连接的数量减少了约一半:结论:与三维 HRUS 相比,MRM 显示了更详细的筋膜描绘,更有能力显示较小的筋膜。虽然三维 HRUS 重建可为周围神经评估提供补充数据,但由于其在描绘筋膜间连接和簇内小筋膜方面存在局限性,因此需要谨慎解读:尽管三维 HRUS 重建可为周围神经评估提供补充数据,即使在术中也是如此,但其在描绘筋膜间分支和簇内小束方面存在局限性,需要谨慎解读:要点:三维 HRUS 在观察神经束间连接方面存在局限性。与三维 HRUS 相比,MRM 对神经束的描绘更好。与三维 HRUS 相比,MRM 能显示更多的神经筋膜间连接。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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3D fascicular reconstruction of median and ulnar nerve: initial experience and comparison between high-resolution ultrasound and MR microscopy.

Background: The complex anatomy of peripheral nerves has been traditionally investigated through histological microsections, with inherent limitations. We aimed to compare three-dimensional (3D) reconstructions of median and ulnar nerves acquired with tomographic high-resolution ultrasound (HRUS) and magnetic resonance microscopy (MRM) and assess their capacity to depict intraneural anatomy.

Methods: Three fresh-frozen human upper extremity specimens were prepared for HRUS imaging by submersion in a water medium. The median and ulnar nerves were pierced with sutures to improve orientation during imaging. Peripheral nerve 3D HRUS scanning was performed on the mid-upper arm using a broadband linear probe (10-22 MHz) equipped with a tomographic 3D HRUS system. Following excision, nerves were cut into 16-mm segments and loaded into the MRM probe of a 9.4-T system (scanning time 27 h). Fascicle and nerve counting was performed to estimate the nerve volume, fascicle volume, fascicle count, and number of interfascicular connections. HRUS reconstructions employed artificial intelligence-based algorithms, while MRM reconstructions were generated using an open-source imaging software 3D slicer.

Results: Compared to MRM, 3D HRUS underestimated nerve volume by up to 22% and volume of all fascicles by up to 11%. Additionally, 3D HRUS depicted 6-60% fewer fascicles compared to MRM and visualized approximately half as many interfascicular connections.

Conclusion: MRM demonstrated a more detailed fascicular depiction compared to 3D HRUS, with a greater capacity for visualizing smaller fascicles. While 3D HRUS reconstructions can offer supplementary data in peripheral nerve assessment, their limitations in depicting interfascicular connections and small fascicles within clusters necessitate cautious interpretation.

Clinical relevance statement: Although 3D HRUS reconstructions can offer supplementary data in peripheral nerve assessment, even in intraoperative settings, their limitations in depicting interfascicular branches and small fascicles within clusters require cautious interpretation.

Key points: 3D HRUS was limited in visualizing nerve interfascicular connections. MRM demonstrated better nerve fascicle depiction than 3D HRUS. MRM depicted more nerve interfascicular connections than 3D HRUS.

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来源期刊
European Radiology Experimental
European Radiology Experimental Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
6.70
自引率
2.60%
发文量
56
审稿时长
18 weeks
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