Many MR Neurography Avatars of Hansen's disease of Peripheral Nerves Revisited with radio pathological correlation

Congress:

ESSR 2017

Poster Number:

P-0180

Type:

Educational Poster

Keywords:

Authors:

R. Vadapalli¹, M. A.K¹, M. Yerasu¹, A. S. Vadapalli², N. Chidambaranathan³; ¹Hyderabad/IN, ²Pune AFMC/IN, ³Chennai/IN

DOI:

10.1594/essr2017/P-0180

DOI-Link:

https://dx.doi.org/10.1594/essr2017/P-0180

Fig. 1: Imaging bio markers of Hansen's disease

Fig. 2: Triple Nerve sign: Thickening of all three major peripheral nerves in the arm...

Fig. 3: 3D MIP of Diffusion(DWIBS) MR neurogram of right upper limb :Shows...

Fig. 4: DWIBS MR Neurography shows Focal and Global Inflammatory Thickening of...

Learning objectives

1. To describe the various pathological correlates of Hansen's Disease (Leprosy)and its conventional MRI and MR Neurography findings. 2. To highlight the role of Diffusion MR Neurography using DWIBS technique and to elucidate various key features of Hansen'sDisease.

Background

Nerve involvement. Leprosy often has an insidious protracted course and may not be recognized early. In leprosy, all physiological functions (sensory, motor, and autonomic) of a peripheral nerve are likely to be affected. Sensory functions are most severely affected. tuberculoid leprosy, involvement of small dermal nerves of cooler parts of the body produces patchy areas of sensory loss. Pain, temperature, touch, and pressure sensations are typically impaired in affected skin areas. Vibration and proprioceptive sensations are spared until later, when nerve trunks are affected. In...

Imaging findings OR Procedure Details

Neuropathological correlates used in detection of the key findings and the following morphological biomarkers A - Focal or diffuse thickening of the nerve. B - Nerve oedema. C - Loss of normal fascicular architecture. D – Peri neural fat stranding. E - Intraneural or juxta neural abscesses. F - Denervation oedema and atrophy and fatty degeneration of the target muscles MR Neurographic Techniques useful for Nerve Imaging in Leprosy 1.Conventional MRI with Fat supression for visualizationof nerves 2.STIR Neurography 3.PROSET Neurography (Water excitation and frequency...

Conclusion

This exhibit familiarizes the viewertypical and atypical MR Neurographic appearancesof Hansen's Disease (Leprosy ) inthecurrent neuroimaging practice.

References

Filler AG, Kliot M, Howe FA, et al. Application of magnetic resonance neurography in the evaluation of patients with peripheral nerve pathology. J Neurosurg 1996;85:299-309. subramanian Subramanian, Raju sharma. Magnetic resonance imaging of ulnar nerve abscess. in leprosy: a Case report. Lepr Rev 2007;78:155–59. Singh G, Ojha D. Leprotic ner ve abscesses. Dermatologica 1969;139:409-12. Kajid Hussain, Birjendra Mishra. Decompression of peripheral trunk in leprosy to prevent development and progression of deformity. Indian Journal of Orthopaedics 2008;42(1

Personal Information

Rammohan Vadapalli [email protected] Senior consulant radiologist Vijya diagnostics ,Hyderabad elangana,India