Peripheral Nerve Imaging

Peripheral nerve imaging has become an essential component in the diagnostic work-up of patients with neuropathies, trauma, entrapment syndromes, and tumors. Magnetic resonance imaging (MRI), particularly MR neurography (MRN), offers high-resolution depiction of nerve anatomy and pathology, especially in deep or complex regions that cannot be assessed with ultrasound. MRI enables characterization of nerve signal changes, continuity, and associated muscle denervation patterns, and it is pivotal in differentiating benign from malignant nerve tumors. The recently proposed MR Neurography Reporting and Data System (MRN-RADS) further facilitates structured evaluation of peripheral nerve tumors. Reliable fat suppression techniques are fundamental to MRN, and sequences such as dual-echo steady state (DESS), enhanced by deep-learning reconstruction, are expanding the diagnostic spectrum. Ultrasound remains valuable for superficial and dynamic assessment, but MRI is the modality of choice when detailed anatomical and functional evaluation is required.