Medical three-dimensional (3D) printing has expanded dramatically over the past three decades with growth in both facility adoption and the variety of medical applications. Consideration for each step required to create accurate 3D printed models from medical imaging data impacts patient care and management. In this paper, a writing group representing the Radiological Society of North America Special Interest Group on 3D Printing (SIG) provides recommendations that have been vetted and voted on by the SIG active membership. This body of work includes appropriate clinical use of anatomic models 3D printed for diagnostic use in the care of patients with specific medical conditions. The recommendations provide guidance for approaches and tools in medical 3D printing, from image acquisition, segmentation of the desired anatomy intended for 3D printing, creation of a 3D-printable model, and post-processing of 3D printed anatomic models for patient care.
MRN has come a long way in the past 2 decades. Excellent depiction of 3D nerve anatomy and pathology is currently possible. Further technical developments in diffusion-based nerve and muscle imaging, whole-body MRN, and nerve-specific MR contrast agents will likely play a major role in advancing this novel field and understanding peripheral neuromuscular diseases in the years to come.
Purpose: To evaluate whether the addition of the threedimensional diffusion-weighted reversed fast imaging with steady state free precession (3D DW-PSIF) sequence improves the identification of peripheral nerves in the distal extremities.Materials and Methods: Twelve MR neurography (MRN) studies of the distal upper extremity and 12 MRN studies of distal lower extremity were evaluated. From the 24 subjects who were enrolled, 10 had clinically suspected peripheral neuropathy, whereas 14 suffered from various orthopedic diseases and had no clinical signs of neuropathy. In each examination, the ability to identify each peripheral nerve on T2-weighted and 3D DW-PSIF sequences was evaluated using a semi-quantitative (0-2) scale. Thereafter, a total certainty score was registered for each sequence.Results: Combining the results of all studies, the mean certainty score was 1.92 6 0.28 on the 3D DW-PSIF images and 1.50 6 0.72 on the T2-weighted images (P < 0.001). In the upper extremity studies, the corresponding certainty scores were 2.0 and 1.70 6 0.55, respectively (P ¼ 0.008), and in the lower extremity studies, 1.86 6 0.35 and 1.36 6 0.79, respectively (P < 0.001).
Conclusion:The 3D DW-PSIF images provide improved identification of the nerves compared with the T2-weighted images, and should be incorporated in the MRN protocol, whenever accurate nerve localization and/or presurgical evaluation are required.
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