Summary. Relevance. Peripheral nerve injury leads to severe limb dysfunction due to denervation, hypotrophy, and skeletal muscle degeneration. Non-invasive visualization methods of these changes are sonography, CT, and MRI.
Objective: to study in the experiment the effect of bone marrow aspirate on the course of denervation and reinnervation processes in skeletal muscles using CT and MRI.
Materials and Methods. The experiment was performed on 36 rabbits, which are divided into four groups: a group of pseudooperated animals, group 1 (neurotomy and sciatic nerve suture), group 2 (on-time injection of bone marrow aspirate), and group 3 (delayed injection of bone marrow aspirate). CT was performed on a Philips Brilliance 16; MRI was performed on a Philips Achieva 1.5 Tesla.
Results. The study results of pseudooperated animals did not differ from the norm. There was a significant (p<0.05) difference in X-ray density between the target muscles of the operated and non-operated limb. The overall larger cross-sectional area of the target muscles was noted in group 2 (median 1.15 cm2), slightly smaller in group 1 (1.1 cm2), and the smallest in group 3 (1.0 cm2). The total X-ray density of the target muscles also differed, with the highest in group 1 (median 69.21 HU), less in group 2 (67.66 HU), and the lowest in group 3 (66.82 HU). We found a significant (p<0.05) difference between the MR signal strength of the target muscles in the T1 mode between groups 1 and 2.
Conclusions. Bone marrow aspirate injection into the target muscles helps reducing muscle swelling. The intensity of the MR signal expression in the T1 mode in the group where the bone marrow aspirate injection was not performed was significantly (p<0.05) greater than in the groups with aspirate injection. The time of bone marrow aspirate injection to the target muscles did not significantly affect the parameters of CT and MRI signal.
Taylor CA, Braza D, Rice BJ, Dillingham T. The Incidence of Peripheral Nerve Injury in Extremity Trauma. American Journal of Physical Medicine & Rehabilitation. 2008; 87(5): 381-385. DOI: 10.1097/PHM.0b013e31815e6370.
Padovano WM, Dengler J, Patterson MM, Yee A, Snyder-Warwick AK, Wood MD, et al. Incidence of Nerve Injury After Extremity Trauma in the United States. HAND. 2020: 1-9. DOI: 10.1177/1558944720963895.
Noland SS, Bishop AT, Spinner RJ, Shin AY. Adult Traumatic Brachial Plexus Injuries. J Am Acad Orthop Surg. 2019; 27(19): 705-716. DOI: 10.5435/JAAOS-D-18-00433.
Birch R. Surgical disorders of the peripheral nerves London: Springer; 2011.
Sugiura Y, Lin W. Neuron-glia interactions: the roles of Schwann cells in neuromuscular synapse formation and function. Biosci Rep. 2011 October; 31(5): 295–302. DOI: 10.1042/BSR20100107.
Jonsson S, Wiberg R, McGrath AM, Novikov LN, Wiberg M, Novikova LN, et al. Effect of Delayed Peripheral Nerve Repair on Nerve Regeneration, Schwann Cell Function and Target Muscle Recovery. PLOS ONE. 2013 February; 8(2): 1-13. DOI: 10.1371/journal.pone.0056484.
Sharma A, Sane H, Gokulchandran N, Badhe P, Pai S, Kulkarni P, et al. Cellular Therapy for Chronic Traumatic Brachial Plexus Injury. Adv Biomed Res. 2018; 27(7): 51. DOI: 10.4103/2277-9175.228631.
Hogendoorn S, Duijnisveld BJ, van Duinen SG, Stoel BC, van Dijk JG, Fibbe WE, et al. Local injection of autologous bone marrow cells to regenerate muscle in patients with traumatic brachial plexus injury. Bone Joint Res. 2014; 3(2): 38-47. DOI: 10.1302/2046-3758.32.2000229.
Zhu Y, Jin Z, Luo Y, Wang Y, Peng N, Peng J, et al. Evaluation of the Crushed Sciatic Nerve and Denervated Muscle with Multimodality Ultrasound Techniques: An Animal Study. Ultrasound Med Biol. 2020; 46(2): 377-392. DOI: 10.1016/j.ultrasmedbio.2019.10.004.
Volk GF, Pohlmann M, Sauer M, Finkensieper M, Guntinas-Lichius O. Quantitative ultrasonography of facial muscles in patients with chronic facial palsy. Muscle Nerve. 2014; 50(3): 358-365. DOI: 10.1002/mus.24154.
Stoll G, Wilder-Smith E, Bendszus M. Imaging of the peripheral nervous system. Handb Clin Neurol. 2013; 115: 137-153. DOI: 10.1016/B978-0-444-52902-2.00008-4.
Connor SEJ, Chaudhary N, Fareedi S, Woo EK. Imaging of muscular denervation secondary to motor cranial nerve dysfunction. Clin Radiol. 2006; 61(8): 659-669. DOI: 10.1016/j.crad.2006.04.003.
Holl N, Echaniz-Laguna A, Bierry G, Mohr M, Loeffler JP, Moser T, et al. Diffusion-weighted MRI of denervated muscle: a clinical and experimental study. Skeletal Radiol. 2008; 37(12): 1111-1117. DOI: 10.1007/s00256-008-0552-2.
Goodpaster BH, Kelley DE, Thaete FL, He J, Ross R. Skeletal muscle attenuation determined by computed tomography is associated with skeletal muscle lipid content. Journal of Applied Physiology. 2000; 89(1): 104-110. DOI: 10.1152/jappl.2000.89.1.104.
van de Sande MAJ, Stoel BC, Obermann WR, Tjong a Lieng JGS, Rozing PM. Quantitative Assessment of Fatty Degeneration in Rotator Cuff Muscles Determined With Computed Tomography. Investigative Radiology. 2005; 40(5): 313-319. DOI: 10.1097/01.rli.0000160014.16577.86.
Kamath S, Venkatanarasimha N, Walsh MA, Hughes PM. MRI appearance of muscle denervation. Skeletal Radiology. 2008; 37(5): 397-404. DOI: 10.1007/s00256-007-0409-0.
Bendszus M, Koltzenburg M, Wessig C, Solymosi L. Sequential MR imaging of denervated muscle: experimental study. AJNR Am J Neuroradiol. 2002; 23(8): 1427-1431. PMCID: PMC7976256.
Tepeli B, Karataş M, Coşkun M, Yemişçi OÜ. A Comparison of Magnetic Resonance Imaging and Electroneuromyography for Denervated Muscle Diagnosis. J Clin Neurophysiol. 2017; 34(3): 248-253. DOI: 10.1097/WNP.0000000000000364.
Kikuchi Y, Nakamura T, Takayama S, Horiuchi Y, Toyama Y. MR imaging in the diagnosis of denervated and reinnervated skeletal muscles: experimental study in rats. Radiology. 2003; 229(3): 861-867. DOI: 10.1148/radiol.2293020904.
West GA, Haynor DR, Goodkin R, Tsuruda JS, Bronstein AD, Kraft G, et al. Magnetic resonance imaging signal changes in denervated muscles after peripheral nerve injury. Neurosurgery. 1994; 35(6): 1077-1085. DOI: 10.1227/00006123-199412000-00010.
This work is licensed under a Creative Commons Attribution 4.0 International License.