Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management

Avneesh Chhabra, Allan J. Belzberg, Gedge D. Rosson, Gaurav K. Thawait, M. Chalian, Sahar J. Farahani, Jaimie T. Shores, Gene Deune, Shar Hashemi, Shrey K. Thawait, Ty Subhawong, John A. Carrino

Research output: Contribution to journalArticle

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Abstract

Objective: To evaluate the impact of magnetic resonance neurography (MRN) on diagnostic thinking and therapeutic choices in patients with suspected peripheral neuropathy. Methods: IRB approval was obtained for this HIPAA-compliant study. Questionnaires were administered to six surgeons regarding the diagnosis and treatment in 85 patients suspected of having peripheral neuropathy, before (pretest) and after (posttest) MRN. Multiple outcome measures related to diagnostic confidence and surgical decision-making were assessed. Results: The final cohort included 81 patients (30 men and 51 women, age 47 ± 17 years). The following changes were observed from pretest to posttest questionnaires: 23 % in nerve involvement (P <0.05), 48 % in degree of confidence of nerve involvement (P <0.01), 27 % in grade of injury (P <0.05), 33 % in differential diagnosis (P <0.05), 63 % in degree of confidence in need for surgery (P <0.001), 41 % in timing of surgery (P <0.01), 30 % in approach to surgery (P <0.05), 58 % in degree of confidence in approach to surgery (P <0.001), 30 % in estimated length of surgery (P <0.05) and 27 % in length of incision (P <0.05). The dichotomous decision regarding surgical or nonsurgical treatment changed from pro to con in 17 %. Conclusion: MRN results significantly influenced the diagnostic thinking and therapeutic recommendations of peripheral nerve surgeons. Key Points: • In patients with peripheral neuropathy, MRN significantly impacts diagnostic thinking.• In patients with peripheral neuropathy, MRN significantly impacts therapeutic choices.• 3-T MRN should be considered in presurgical planning of patients with peripheral neuropathy.

Original languageEnglish (US)
JournalEuropean Radiology
DOIs
StateAccepted/In press - Sep 22 2015

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Peripheral Nervous System Diseases
Therapeutics
Health Insurance Portability and Accountability Act
Research Ethics Committees
Peripheral Nerves
Thinking
Decision Making
Differential Diagnosis
Magnetic Resonance Spectroscopy
Outcome Assessment (Health Care)
Wounds and Injuries
Surveys and Questionnaires
Surgeons

Keywords

  • Decision-making
  • Diagnostic approach
  • MR neurography
  • Peripheral nerve injury
  • Therapeutic management

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Chhabra, A., Belzberg, A. J., Rosson, G. D., Thawait, G. K., Chalian, M., Farahani, S. J., ... Carrino, J. A. (Accepted/In press). Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management. European Radiology. https://doi.org/10.1007/s00330-015-3958-y

Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management. / Chhabra, Avneesh; Belzberg, Allan J.; Rosson, Gedge D.; Thawait, Gaurav K.; Chalian, M.; Farahani, Sahar J.; Shores, Jaimie T.; Deune, Gene; Hashemi, Shar; Thawait, Shrey K.; Subhawong, Ty; Carrino, John A.

In: European Radiology, 22.09.2015.

Research output: Contribution to journalArticle

Chhabra, A, Belzberg, AJ, Rosson, GD, Thawait, GK, Chalian, M, Farahani, SJ, Shores, JT, Deune, G, Hashemi, S, Thawait, SK, Subhawong, T & Carrino, JA 2015, 'Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management', European Radiology. https://doi.org/10.1007/s00330-015-3958-y
Chhabra, Avneesh ; Belzberg, Allan J. ; Rosson, Gedge D. ; Thawait, Gaurav K. ; Chalian, M. ; Farahani, Sahar J. ; Shores, Jaimie T. ; Deune, Gene ; Hashemi, Shar ; Thawait, Shrey K. ; Subhawong, Ty ; Carrino, John A. / Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management. In: European Radiology. 2015.
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abstract = "Objective: To evaluate the impact of magnetic resonance neurography (MRN) on diagnostic thinking and therapeutic choices in patients with suspected peripheral neuropathy. Methods: IRB approval was obtained for this HIPAA-compliant study. Questionnaires were administered to six surgeons regarding the diagnosis and treatment in 85 patients suspected of having peripheral neuropathy, before (pretest) and after (posttest) MRN. Multiple outcome measures related to diagnostic confidence and surgical decision-making were assessed. Results: The final cohort included 81 patients (30 men and 51 women, age 47 ± 17 years). The following changes were observed from pretest to posttest questionnaires: 23 {\%} in nerve involvement (P <0.05), 48 {\%} in degree of confidence of nerve involvement (P <0.01), 27 {\%} in grade of injury (P <0.05), 33 {\%} in differential diagnosis (P <0.05), 63 {\%} in degree of confidence in need for surgery (P <0.001), 41 {\%} in timing of surgery (P <0.01), 30 {\%} in approach to surgery (P <0.05), 58 {\%} in degree of confidence in approach to surgery (P <0.001), 30 {\%} in estimated length of surgery (P <0.05) and 27 {\%} in length of incision (P <0.05). The dichotomous decision regarding surgical or nonsurgical treatment changed from pro to con in 17 {\%}. Conclusion: MRN results significantly influenced the diagnostic thinking and therapeutic recommendations of peripheral nerve surgeons. Key Points: • In patients with peripheral neuropathy, MRN significantly impacts diagnostic thinking.• In patients with peripheral neuropathy, MRN significantly impacts therapeutic choices.• 3-T MRN should be considered in presurgical planning of patients with peripheral neuropathy.",
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AU - Chhabra, Avneesh

AU - Belzberg, Allan J.

AU - Rosson, Gedge D.

AU - Thawait, Gaurav K.

AU - Chalian, M.

AU - Farahani, Sahar J.

AU - Shores, Jaimie T.

AU - Deune, Gene

AU - Hashemi, Shar

AU - Thawait, Shrey K.

AU - Subhawong, Ty

AU - Carrino, John A.

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N2 - Objective: To evaluate the impact of magnetic resonance neurography (MRN) on diagnostic thinking and therapeutic choices in patients with suspected peripheral neuropathy. Methods: IRB approval was obtained for this HIPAA-compliant study. Questionnaires were administered to six surgeons regarding the diagnosis and treatment in 85 patients suspected of having peripheral neuropathy, before (pretest) and after (posttest) MRN. Multiple outcome measures related to diagnostic confidence and surgical decision-making were assessed. Results: The final cohort included 81 patients (30 men and 51 women, age 47 ± 17 years). The following changes were observed from pretest to posttest questionnaires: 23 % in nerve involvement (P <0.05), 48 % in degree of confidence of nerve involvement (P <0.01), 27 % in grade of injury (P <0.05), 33 % in differential diagnosis (P <0.05), 63 % in degree of confidence in need for surgery (P <0.001), 41 % in timing of surgery (P <0.01), 30 % in approach to surgery (P <0.05), 58 % in degree of confidence in approach to surgery (P <0.001), 30 % in estimated length of surgery (P <0.05) and 27 % in length of incision (P <0.05). The dichotomous decision regarding surgical or nonsurgical treatment changed from pro to con in 17 %. Conclusion: MRN results significantly influenced the diagnostic thinking and therapeutic recommendations of peripheral nerve surgeons. Key Points: • In patients with peripheral neuropathy, MRN significantly impacts diagnostic thinking.• In patients with peripheral neuropathy, MRN significantly impacts therapeutic choices.• 3-T MRN should be considered in presurgical planning of patients with peripheral neuropathy.

AB - Objective: To evaluate the impact of magnetic resonance neurography (MRN) on diagnostic thinking and therapeutic choices in patients with suspected peripheral neuropathy. Methods: IRB approval was obtained for this HIPAA-compliant study. Questionnaires were administered to six surgeons regarding the diagnosis and treatment in 85 patients suspected of having peripheral neuropathy, before (pretest) and after (posttest) MRN. Multiple outcome measures related to diagnostic confidence and surgical decision-making were assessed. Results: The final cohort included 81 patients (30 men and 51 women, age 47 ± 17 years). The following changes were observed from pretest to posttest questionnaires: 23 % in nerve involvement (P <0.05), 48 % in degree of confidence of nerve involvement (P <0.01), 27 % in grade of injury (P <0.05), 33 % in differential diagnosis (P <0.05), 63 % in degree of confidence in need for surgery (P <0.001), 41 % in timing of surgery (P <0.01), 30 % in approach to surgery (P <0.05), 58 % in degree of confidence in approach to surgery (P <0.001), 30 % in estimated length of surgery (P <0.05) and 27 % in length of incision (P <0.05). The dichotomous decision regarding surgical or nonsurgical treatment changed from pro to con in 17 %. Conclusion: MRN results significantly influenced the diagnostic thinking and therapeutic recommendations of peripheral nerve surgeons. Key Points: • In patients with peripheral neuropathy, MRN significantly impacts diagnostic thinking.• In patients with peripheral neuropathy, MRN significantly impacts therapeutic choices.• 3-T MRN should be considered in presurgical planning of patients with peripheral neuropathy.

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KW - Peripheral nerve injury

KW - Therapeutic management

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