Plastic and Reconstructive Surgery, Global Open (Aug 2024)

MRI and Ultrasound Visualization of a Nerve Repair Implant Containing Nitinol

  • Michelle Akerman, MS,
  • Darryl B. Sneag, MD,
  • Lisa Gfrerer, MD, PhD,
  • Yoshimi Endo, MD,
  • Alyssa B. Valenti, MD,
  • Isaac P. Clements, PhD,
  • Ek T. Tan, PhD

DOI
https://doi.org/10.1097/GOX.0000000000006063
Journal volume & issue
Vol. 12, no. 8
p. e6063

Abstract

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Background:. Nerve Tape is a novel nerve repair device containing nitinol microhooks that provide sutureless attachment for nerve coaptation. This study evaluated visualization of Nerve Tape on magnetic resonance imaging (MRI) and ultrasound, with the objective of exploring its potential as an imaging marker for localizing nerve repair sites. Methods:. Phantom imaging experiments were first conducted to assess the visibility of Nerve Tape on MRI and ultrasound. A cadaveric limb investigation was then performed to further characterize the magnetic susceptibility patterns of Nerve Tape and to confirm its localization at the repair site. Results:. Phantom imaging experiments demonstrated clear visualization of Nerve Tape on both MRI and ultrasound, with Nerve Tape microhooks appearing as signal voids on MRI and hyperechoic foci on ultrasound. Subsequent cadaveric limb investigation further characterized Nerve Tape’s magnetic susceptibility patterns and confirmed localization of the device at the repair site. The physical dimensions of Nerve Tape and locations observed on both MRI and ultrasound matched design and measurements made during surgery. Measurement discrepancies could be attributed to magnetic susceptibility artifacts in MRI, and to comet tail and shadowing effects in ultrasound. Conclusions:. Repairs performed with Nerve Tape can be reliably localized for imaging, potentially facilitating assessment of repair site integrity and further advancement toward image-based monitoring of nerve regeneration. Further research, including in vivo human studies, is warranted to confirm these preliminary findings.