Objective

Diffusion kurtosis imaging (DKI) has been proven to provide additional value for assessing many central nervous system diseases compared with conventional diffusion tensor imaging (DTI); however, whether it has the same value in peripheral nerve injury is unclear. This study aimed to investigate the performance of DKI, DTI, and electromyography (EMG) in evaluating peripheral nerve crush injury (PNCI) in rabbits.

Materials and methods

A total of 27 New Zealand white rabbits were selected to establish a PNCI model. Longitudinal DTI, DKI, and EMG were evaluated before surgery and 1 day, 3 days, 1 week, 2 weeks, 4 weeks, 6 weeks, and 8 weeks after surgery. At each time point, two rabbits were randomly selected for pathological examination.

Results

The results showed that fractional anisotropy (FA) derived from both DKI and DTI demonstrated a significant difference between injured and control nerves at all time points (all P < 0.005) mean kurtosis of the injured nerve was lower than that on the control side after 2–8 weeks (all P < 0.05). No statistically significant difference was found in radial kurtosis, axial kurtosis, and apparent diffusion coefficient at almost every time point. The difference in compound muscle action potential (CMAP) of the bilateral gastrocnemius at each time point was statistically significant (all P < 0.001).

Conclusions

CMAP was a sensitive and reliable method to assess acute PNCI without being affected by perineural edema. DKI may not be superior to DTI in evaluating peripheral nerves, DTI with a shorter scanning time was preferred as an effective choice for evaluating acute peripheral nerve traumatic injury.

中文翻译：

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兔周围神经急性挤压伤的评估：弥散峰度成像、弥散张量成像和肌电图的比较

客观的

与传统的扩散张量成像 (DTI) 相比，扩散峰度成像 (DKI) 已被证明可以为评估许多中枢神经系统疾病提供额外的价值；然而，它在周围神经损伤中是否具有相同的价值尚不清楚。本研究旨在探讨 DKI、DTI 和肌电图 (EMG) 在评估兔周围神经挤压损伤 (PNCI) 中的性能。

材料和方法

选取27只新西兰大白兔建立PNCI模型。术前和术后 1 天、3 天、1 周、2 周、4 周、6 周和 8 周评估纵向 DTI、DKI 和 EMG。每个时间点随机抽取2只家兔进行病理检查。

结果

结果表明，来自 DKI 和 DTI 的分数各向异性 (FA) 在所有时间点均显示损伤神经和对照神经之间存在显着差异（均P  < 0.005），2 次后损伤神经的平均峰度低于对照侧–8 周（所有P  < 0.05）。几乎在每个时间点，径向峰度、轴向峰度和表观扩散系数均无统计学差异。各时间点双侧腓肠肌复合肌肉动作电位（CMAP）差异有统计学意义（均P  <0.001）。

结论

CMAP 是一种敏感且可靠的评估急性 PNCI 的方法，不受神经周围水肿的影响。DKI在评估周围神经方面可能不优于DTI，扫描时间较短的DTI是评估急性周围神经外伤的有效选择。