MR-Neurography of the sural nerve in patients with hereditary amyloidosis

Background Sural nerve biopsies are often performed in order to detect the underlying disease in patients suffering from unclear polyneuropathic symptoms. In transthyretin familial amyloid-polyneuropathy (TTR-FAP) the diagnostic value of invasive sural nerve biopsies is controversially discussed as it often lacks to detect amyloid deposits [Simmons et al, J Neurol Sci 1993]. As we recently reported, amyloid related nerve-injury in TTR-FAP can be unambiguously determined in large-caliber nerves (sciatic, tibial and common peroneal nerve) by applying high-resolution MR-Neurography (MRN) [Kollmer et al, Brain 2015]. However, the diagnostic yield of MRN of the small-caliber sural nerve, representing the target nerve specimen for biopsies, is still unclear and was subject to this investigation.