This thesis describes the development and applications of quantitative MRI and combined EMG and MRI study of Brachial Plexus. The protocols developed in this thesis have been used on normal healthy subjects, aiming at characterizing the tissues based on their MR and EMG parameters. The Brachial Plexus is the upper portion of the peripheral nervous system and controls the movements of shoulder and arms. Neurological disorders in the brachial plexus can result from cervical spondylotic neuropathy due to compression of nerve roots exiting from vertebra or compression of the spinal cord due to bulging discs. MRI provides the opportunity to obtain precise information on the location of these disorders and to provide quantitative biomarkers. EMG in the form of the distribution of F-latency (DFL) is a recently introduced nerve conduction parameter that can detect functional symptoms with such disorders. To study the brachial plexus the diffusion weighted MRI with body signal suppression (DWIBS) technique was used to highlight the nerves from surrounding tissues. This technique was then used to investigate the diffusivity of water molecules in the peripheral nerve axon. The diffusion time dependency of the diffusion coefficient was used to study the presence of restricted diffusion in the brachial plexus. A clear reduction of the apparent diffusion coefficient was observed with long diffusion times and confirmed the restricted diffusion in nerves and cord. The T2 relaxation was used to investigate the properties of intercellular and intracellular space in peripheral nerves. Diffusion weighting dependency of T2 and echo time dependency of apparent diffusion coefficient (ADC) was observed in initial studies. The magnetisation transfer (MT) and z-spectra were used to study macromolecular characteristics and exchange mechanisms. Asymmetry in z-spectra both for nerves and spinal cord was observed, this relates to possible detection of the nuclear overhauser effect (NOE) in the brachial plexus. Quantitative MRI studies showed that these parameters can be used as important biomarkers for neurological studies in the brachial plexus. The DFL, representing the motor nerve fibres conduction characteristics, was measured for normal healthy nerves and combined with MR parameters. Correlation between DFL and MR parameters was observed for the first time.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:639876 |
| Date | January 2014 |
| Creators | Mahbub, Zaid Bin |
| Publisher | University of Nottingham |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://eprints.nottingham.ac.uk/14412/ |
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