Health Organization for Pudendal Education

Hi, I am considering whether to get a pelvic Dr. Filler MRN or a 3T Tesla Dr. Potter MRI to find the exact location of my PNE. I can not really find any information anywhere that compares the two different types of diagnostic imaging in finding pudendal nerve entrapment. From what I have seen, it looks as though the MRN is good at seeing PNE but I was wondering if anybody has any proof or studies that Dr. Potter's 3T MRI is better than the MRN for finding PNE because I can't seem to find any? I have seen people post some results of their Dr. Potter MRI, but nobody has said anything about the MRN? I know the MRN is more expensive and I think insurance might not cover it but it does cover MRIs. The MRN may actually be better than Dr. Potter's MRI, but I have no information that compares the two. I was given the following information below from Dr. Filler's MRN office but do not have any published peer review studies comparing the two methods yet:

"I wanted to take time to clarify the difference between MR Neurography and 3T MRI. Many patients are often confused or do not fully understand the difference between MR Neurography and 3T MRI. In the case of soft tissue injury and nerve imaging outside of the spinal column, bigger is not necessarily better. You have to consider the issue of what you are trying to accomplish with MRI scanning. Yes, 3T is a higher Tesla magnet however it is the very speed and added strength of the magnet which makes nerve details more difficult to see on these types of scanners. Faster is actually not conducive to nerve imaging, so if you are trying to distinguish between soft tissue elements and find out if there are impinged nerve roots adjacent to disc space, if there are entrapped nerve branches, if there is scar tissue encapsulating the nerve, or muscle anomaly that is restricting nerve function, then MR Neurography is the best for deducing these diagnostic factors"

Thanks
Shawn

Below is a link to a thread that discusses your question.

http://www.pudendalhope.info/forum/view ... f=69&t=319

I was so impressed with the results people were posting of their MRIs with Dr. Potter on this board that I had mine done in Feb. 2011 and what she found with my pudendal nerve entrapments matched my symptoms almost perfectly. I have not seen anyone post their MRN results on this board, I may have missed it if someone has so if I am incorrect someone please speak up. Also, Dr. Potter's MRI will look at the other nerves in the pelvis and any other potential problem one might have in the pelvis for example tendinosis, torn muscles, cysts. I'm not sure the MRN will give any other type of information. If you are lucky and if she is not busy she will sit and go over the MRI with you. You won't get that with the MRN.

Thanks NYT for replying and posting your experienc. It seems as if Potters MRI is good, but I would still like anybody to post any positive results from an MRN or any real case studies or peer reviews or comparisons of results between the MRN and Potter MRI. I am still not ruling out an MRN and still think it may be equal to or better than a Potter MRI until I see any proof otherwise. Thanks

Shawn

hi, just to add on, I have had both done. My Filler MRN did not match up with my symptomology, whereas my Potter MRI did, and showed much more.

There are no publications on Dr. Potter's MRI of the pudendal nerve. She has multiple other publications on MRI's for other areas of the body. I would imagine she will published with Dr. HIbner, at some point, comparing the findings of her MRI with intraoperative verification and patient symptomology. Dr. Filler has a publication of the MRN of the pudendal nerve in a publication he did a couple of years ago. He also has other publications on his initial development of the MRN. There is a publication by Dr. Dellon where the the MRN of nerves in the wrist matched quite well with intraoperative findings. Only you can decide what is best for you.

At least 2 Hibner surgeries validated Potter. Also, Potter/HSS seem to take insurance.
Take care,
RR

I had both and Dr. Potter's matched my symptoms to a T, were validated by a MRI guided nerve block. Go with Dr Potter for insurance, cost, and accuracy over the MRN.

Dr. Potter's MRI (1.5T because of my metal hip) matched my symptoms exactly. Scarring at rt ST ligament at exact spot where pain was elicited by internal exam. As said before, covered by insurance and she went over the pictures with me. Dr. Filler's track record (at least on this forum) at finding and fixing extrapments is pretty bad. If someone has been fixed by Dr. Filler, I hope that they would tell us about it here. With all those successes he talks about on his website, there must be one or two out there who are willing to come forward. He owns that MRN technology so there is no way for other providers to evaluate it.

Don

I say go ahead and schedule an appt with Potter; I couldn't get in until late September. That will give you time to make up your mind.

I went ahead and went with Potter for the MRI instead of the Filler MRN, because my insurance covered it for one thing:) It showed varices (enlarged veins) on both sides of the dorsal nerve, which is where my greatest pain is.