Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
Clin Neuroradiol. 2019 Dec;29(4):631-638. doi: 10.1007/s00062-018-0706-0. Epub 2018 Jul 23.
The close proximity of blood vessels to the brachial plexus nerves can confound nerve visualization in conventional fat-suppressed 3D T2-weighted sequences. Vessel suppression can be accomplished by means of motion-sensitizing preparation. The aim of this study was to qualitatively and semi-quantitatively evaluate short tau inversion recovery (STIR) 3D turbo spin echo (TSE) in conjunction with an adiabatic T2 preparation incorporating motion sensitization for magnetic resonance neurography (MRN) of the brachial plexus in a clinical routine setting.
The MRN of the brachial plexus was performed in 22 patients (age 45.5 ± 20.3 years) with different clinical implications using the proposed improved motion-sensitized driven equilibrium (iMSDE) STIR 3D TSE and the STIR 3D TSE. Images were evaluated regarding image quality, overall artifacts, artifacts caused by vessel signal, signal homogeneity, visibility of small nerves and signal contrast. Furthermore, signal-to-noise ratios (aSNR), nerve muscle contrast to noise ratios (aNMCNR) and nerve vessel contrast to noise ratios (aNVCNR) were calculated and compared.
The incorporation of motion sensitization in the T2 preparation resulted in robust blood suppression across subjects, leading to significantly higher aNVCNRs (p < 0.001) and aNMCNRs (p < 0.05), increased conspicuousness of the nerves, better vessel suppression and image quality and less artifacts compared with STIR 3D TSE (p < 0.001).
The incorporation of the proposed adiabatic iMSDE-based motion sensitization was shown to provide robust blood suppression of vessels in close proximity to brachial plexus nerves. The use of STIR iMSDE 3D TSE can be considered for clinical MRN examinations of the brachial plexus.
血管与臂丛神经毗邻，这使得在常规的脂肪抑制 3D T2 加权序列中观察神经变得复杂。血管抑制可以通过运动敏感准备来实现。本研究的目的是定性和半定量评估短反转时间反转恢复（STIR）3D 涡轮自旋回波（TSE）结合采用运动敏感的绝热 T2 准备，用于在临床常规环境下进行臂丛磁共振神经成像（MRN）。
对 22 例具有不同临床意义的患者（年龄 45.5±20.3 岁）进行臂丛 MRN，使用所提出的改进的运动敏感驱动平衡（iMSDE）STIR 3D TSE 和 STIR 3D TSE。对图像的质量、整体伪影、血管信号引起的伪影、信号均匀性、小神经的可见度和信号对比度进行评估。此外，还计算并比较了信噪比（aSNR）、神经肌肉对比噪声比（aNMCNR）和神经血管对比噪声比（aNVCNR）。
在 T2 准备中加入运动敏感，在所有受试者中均能得到稳健的血液抑制，导致 aNVCNR（p<0.001）和 aNMCNR（p<0.05）显著提高，神经更显眼，血管抑制和图像质量更好，伪影更少，与 STIR 3D TSE 相比差异有统计学意义（p<0.001）。
所提出的基于绝热 iMSDE 的运动敏感的加入被证明可以提供臂丛神经附近血管的稳健血液抑制。在临床臂丛磁共振神经成像检查中可以考虑使用 STIR iMSDE 3D TSE。
