European Radiology

, Volume 27, Issue 6, pp 2359–2366 | Cite as

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
Magnetic Resonance



To investigate the feasibility of diffusion-weighted magnetic resonance neurography (DW-MRN) in the visualisation of extremity nerves in the wrist and palm.


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).


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).


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


MR neurography Diffusion-weighted imaging Median nerve Ulnar nerve Wrist 



diffusion-weighted magnetic resonance neurography


proton density weighted


fat suppressed proton density weighted imaging


carpal tunnel syndrome


median nerve


ulnar nerve


diffusion-weighted whole-body imaging with background body signal suppression


motion-probing gradient


number of excitations



The scientific guarantor of this publication is Guangbin Wang. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work was supported by the National Natural Science Foundation of China under Grant Nos. 81371534, 81171380. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent form was obtained from subjects or their parents in this study. This article has not been published elsewhere in whole or in part. Methodology: prospective, experimental, performed at one institution.


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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Hongjing Bao
    • 1
  • Shanshan Wang
    • 1
  • Guangbin Wang
    • 1
  • Li Yang
    • 2
  • Mansoor-ul Hasan
    • 1
  • Bin Yao
    • 1
  • Chao Wu
    • 1
  • Xu Zhang
    • 3
  • Weibo Chen
    • 4
  • Queenie Chan
    • 4
  • Lebin Wu
    • 1
  • Avneesh Chhabra
    • 5
  1. 1.Department of MR, Shandong Medical Imaging Research Institute Affiliated to Shandong UniversityShandong UniversityJinanPeople’s Republic of China
  2. 2.Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan HospitalFudan UniversityShanghaiPeople’s Republic of China
  3. 3.Department of RadiologyShandong Chest HospitalJinanPeople’s Republic of China
  4. 4.Philips HealthcareShanghaiPeople’s Republic of China
  5. 5.UT Southwestern Medical CenterDallasUSA

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