{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T05:15:59Z","timestamp":1791522959024,"version":"4.3.4"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"1122","license":[{"start":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T00:00:00Z","timestamp":1620345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>To evaluate the utility and efficacy of MR neurography (MRN) in the diagnostic work-up for intercostal neuralgia and to assess the treatment course and outcomes in MRN-imaged clinically suspected intercostal neuropathy cases of chronic chest and abdominal wall pain syndromes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>Following a retrospective cross-sectional study, a consecutive series of patients who underwent MRN of torso for suspected intercostal neuralgia were included. Patient demographics, pain location\/level\/duration, previous work-up for the same indication, MRN imaging results, and MRN cost per patient were recorded. An inter-reader reliability assessment was performed on the MRN findings using Cohen\u2019s weighted \u03ba analysis. Post-MRN treatment choice, as well as success rates of MRN directed perineural injections and surgical management were also evaluated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>A total of 28 patients (mean \u00b1 SD\u2009age, 48.3 \u00b1 18.0 years, female\/male = 3.0) were included. Pain and\/or numbness in the right upper quadrant were the most common complaints. The mean maximum pain level experienced was 7.4 \u00b1 2.5 on a 1 (lowest pain level) - 10 (highest pain level) visual analog scale. The duration of pain before MRN work-up was 36.9 \u00b1 37.9 months. The patients had seen an average of 5 \u00b1 2.8 physicians for such syndromes. 20 (71%) patients had one or multiple other imaging studies for prior work-up. MRN identified positive intercostal nerve abnormality in 19 cases with clinical symptoms of intercostal neuralgia. From the inter-reader reliability assessment, a Cohen\u2019s weighted \u03ba value of 0.78 was obtained. The costs of work-up was about one-third with MRN for diagnostic purposes with less financial and psychological harm. Among the MRN-positive cases, 9\/19 patients received perineural injections, of which 6 reported improvement after their first round, lasting an average of 41.1 \u00b1 83 days. Among the nine MRN-negative cases, two received perineural injections, of which none reported improvement. Surgical management was mostly successful with a positive outcome in six out of seven operated cases (85.7%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>MRN is useful in diagnostic algorithm of intercostal neuralgia and MRN-positive cases demonstrate favorable treatment response to perineural injections and subsequent surgical management.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Advances in knowledge:<\/jats:title>\n                  <jats:p>The use of MRN in intercostal neuralgia is an application that has not been previously explored in the literature. This study demonstrates that MRN offers superior visualization of pathology in intercostal neuralgia and confirms that treatment directed at MRN identified neuropathy results in good outcomes while maintaining cost efficiency.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1259\/bjr.20200603","type":"journal-article","created":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T15:46:54Z","timestamp":1620402414000},"source":"Crossref","is-referenced-by-count":7,"title":["Role of magnetic resonance neurography in intercostal neuralgia; diagnostic utility and efficacy"],"prefix":"10.1093","volume":"94","author":[{"given":"Majid","family":"Chalian","sequence":"first","affiliation":[{"name":"Department of Radiology, Musculoskeletal Imaging and Intervention, University of Washington , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Hoang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Musculoskeletal Radiology, University of Texas Southwestern Medical Center , Dallas, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shai","family":"Rozen","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University of Texas Southwestern Medical Center , Dallas, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avneesh","family":"Chhabra","sequence":"additional","affiliation":[{"name":"Department of Radiology, Musculoskeletal Radiology, University of Texas Southwestern Medical Center , Dallas, TX , USA"},{"name":"Department of Orthopedics, University of Texas Southwestern Medical Center , Dallas, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,5,7]]},"reference":[{"key":"2024050215454811700_b1","doi-asserted-by":"crossref","DOI":"10.1212\/WNL.52.9.1917","article-title":"Topiramate relieves refractory intercostal 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