Method for diagnostically imaging lesions in the peripheral nervous system

Abstract

An improved method for diagnosing and characterizing peripheral nerve lesions to permit early identification and characterization of peripheral nerve injuries that will require surgical intervention.

What is claimed is: 
     
         1 . A method to characterize peripheral nerve lesions for surgical intervention by detecting blood-nerve barrier permeability, the method including the steps of:
 introducing a chemical agent to a peripheral nerve having a blood-nerve barrier, the chemical agent operable to interact with an epitope within the blood-nerve barrier;   detecting blood-nerve barrier permeability by analyzing the peripheral nerve to detect an amount of the chemical agent at a site of the blood-nerve barrier permeability, the blood-nerve barrier permeability caused by a lesion; and   characterizing the peripheral nerve lesion as one for surgical intervention if the chemical agent interacts with the epitope,   wherein the chemical agent (i) does not interact with the epitope unless the blood-nerve barrier is permeable and allows the epitope to be exposed to the chemical agent, and (ii) is operable to localize at the site of the blood-nerve barrier permeability, and the method does not include modification of the blood-nerve barrier permeability.   
     
     
         2 . The method of  claim 1 , further comprising the step of attaching a label to the chemical agent, wherein the chemical agent is operable to localize in regions where the blood-nerve barrier is disrupted. 
     
     
         3 . The method of  claim 2 , wherein the analyzing of the peripheral nerve includes determining the amount of the chemical agent present in the peripheral nerve. 
     
     
         4 . The method of  claim 1 , wherein the chemical agent is a monoclonal antibody. 
     
     
         5 . The method of  claim 1 , wherein the chemical agent is operable to bind exclusively to the peripheral nerve lesions. 
     
     
         6 . The method of  claim 1 , wherein the chemical agent is an antibody against an axonal protein. 
     
     
         7 . The method of  claim 1 , wherein the blood-nerve barrier is permeable due to neurotmesis. 
     
     
         8 . The method of  claim 1 , wherein, the lesion features (i) a loss of axons, and (ii) disruption of endoneurium and perineurium. 
     
     
         9 . The method of  claim 1 , wherein the lesion is a neurotmetic lesion or related to birth palsy. 
     
     
         10 . The method of  claim 1 , wherein the lesion is the result of a gunshot injury. 
     
     
         11 . The method of  claim 1 , wherein the lesion is a related to a closed injury. 
     
     
         12 . The method of  claim 11 , wherein the closed injury is a bone fracture. 
     
     
         13 . A method to diagnose surgical intervention of a nerve injury using a chemical agent having a label by detecting permeability of a blood-nerve barrier of a peripheral nerve, the method including the steps of:
 introducing the chemical agent having the label to the blood-nerve barrier, the chemical agent operable to bind to an epitope exposed at a permeable site of the blood-nerve barrier; and   detecting blood-nerve barrier permeability by imaging the peripheral nerve using magnetic resonance imaging to determine a presence of the chemical agent at the permeable site of the blood-nerve barrier, wherein the blood-nerve barrier permeability is caused by an injury, the permeable site of the blood-nerve barrier is a disruption in the blood-nerve barrier, and the chemical agent is operable to localize in regions where the blood-nerve barrier is disrupted; and   diagnosing the nerve injury for surgical intervention if the chemical agent localizes at the peripheral nerve,   wherein the label is (i) attached to the chemical agent, (ii) a contrast agent, and (iii) operable to localize and be detected at peripheral nerve injury sites that demonstrate blood-nerve barrier permeability via the magnetic resonance imaging.   
     
     
         14 . The method of  claim 13 , wherein the permeable site of the blood-nerve barrier is caused by a lesion. 
     
     
         15 . The method of  claim 14 , wherein the lesion features (i) a loss of axons, and (ii) disruption of endoneurium and perineurium. 
     
     
         16 . The method of  claim 13 , wherein the injury is a neurotmetic injury, an injury related to birth palsy, a gunshot injury, or a closed injury. 
     
     
         17 . The method of  claim 16 , wherein the injury is a closed injury, and the closed injury is a bone fracture. 
     
     
         18 . The method of  claim 13 , wherein, the method does not include modification of permeability of the blood-nerve barrier. 
     
     
         19 . The method of  claim 13 , wherein the label is gadolinium-DTPA or superparamagnetic iron oxide nanoparticles.