Diffusion-weighted MR neurography of median and ulnar nerves in the wrist and palm

Hongjing Bao, Shanshan Wang, Guangbin Wang, Li Yang, Mansoor ul Hasan, Bin Yao, Chao Wu, Xu Zhang, Weibo Chen, Queenie Chan, Lebin Wu, Avneesh Chhabra

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Objectives: To investigate the feasibility of diffusion-weighted magnetic resonance neurography (DW-MRN) in the visualisation of extremity nerves in the wrist and palm. Methods: Thirty-two volunteers and 21 patients underwent imaging of the wrist and palm on a 3-T MR scanner. In all subjects, two radiologists evaluated the image quality on DW-MRN using a four-point grading scale. Kappa statistics were obtained for inter-observer performance. In volunteers, the chi-squared test was used to assess the differences in nerve visualisation on DW-MRN and axial fat-suppressed proton density weighted imaging (FS-PDWI). Results: In volunteers, the mean image quality scores for the median nerve (MN) and ulnar nerve (UN) were 3.71 ± 0.46 and 3.23 ± 0.67 for observer 1, and 3.70 ± 0.46 and 3.22 ± 0.71 for observer 2, respectively. The inter-observer agreement was excellent (k = 0.843) and good (k = 0.788), respectively. DW-MRN provided significantly improved visualisations of the second and the third common palmar digital nerves and three branches of UN compared with FS-PDWI (P < 0.05). In patients, the mean image quality scores for the two observers were 3.24 ± 0.62 and 3.10 ± 0.83, inter-observer performance was excellent (k = 0.842). Conclusions: DW-MRN is feasible for improved visualisation of extremity nerves and their lesions in the wrist and palm with adequate image quality, thereby providing a supplementary method to conventional MR imaging. Key points: • DW-MRN provides adequate image quality for wrist and palm neurography • DW-MRN performs similarly to FS-PDWI in nerve visualisation at the wrist • DW-MRN provides improved visualisation of small nerves in the palm • DW-MRN serves as a supplementary method to evaluate peripheral neuropathies.

Original languageEnglish (US)
Pages (from-to)2359-2366
Number of pages8
JournalEuropean Radiology
Issue number6
StatePublished - Jun 1 2017


  • Diffusion-weighted imaging
  • MR neurography
  • Median nerve
  • Ulnar nerve
  • Wrist

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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