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Neurorehabilitation and Neural Repair
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High-Resolution Magnetic Resonance Imaging of the Human Median Nerve

Archie Heddings

Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, Kansas

Mehmet Bilgen

Hoglund Brain Imaging Center, Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas

Randolph Nudo

Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas

Bruce Toby

Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, Kansas btoby{at}kumc.edu

Terence McIff

Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, Kansas

William Brooks

Hoglund Brain Imaging Center, Molecular and Integrative Physiology, and Neurology, University of Kansas Medical Center, Kansas City, Kansas

Objectives. It is widely accepted that peripheral nerve repairs performed within 6 weeks of injury have much better outcomes than those performed at later dates. However, there is no diagnostic technique that can determine if a traumatic peripheral nerve injury requires surgical intervention in the early postinjury phase. The objective of this article was to determine whether novel, noninvasive magnetic resonance imaging techniques could demonstrate the microstructure of human peripheral nerves that is necessary for determining prognosis and determining if surgery is indicated following traumatic injury. Methods. Ex vivo magnetic resonance imaging protocols were developed on a 9.4-T research scanner using spin-echo proton density and gradient-echo imaging sequences and a specially designed, inductively coupled radio frequency coil. These imaging protocols were applied to in situ imaging of the human median nerve in 4 fresh-frozen cadaver arms. Results. Noninvasive high-resolution images of the human median nerve were obtained. Structures in the nerve that were observed included fascicles, interfascicular epineurium, perineurium, and intrafascicular septations. Conclusion. Application of these imaging techniques to clinical scanners could provide physicians with a tool that is capable of grading the severity of nerve injuries and providing indications for surgery in the early postinjury phase.

Key Words: Magnetic resonance imaging • peripheral nerve • median merve • traumatic peripheral nerve injury • median nerve injury

Neurorehabilitation and Neural Repair, Vol. 18, No. 2, 80-87 (2004)
DOI: 10.1177/0888439004267074
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