High-Resolution 3T MR Neurography of the Brachial Plexus and Its Branches, with Emphasis on 3D Imaging

Chhabra, Avneesh; Thawait, Gaurav K.; Soldatos, Theodoros; Thakkar, Rashmi S.; Grande, Filippo Del; Chalian, Majid; Carrino, John A.

doi:10.3174/ajnr.a3287

Cited by 127 publications

(90 citation statements)

References 32 publications

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“…It has been demonstrated recently that 3D TSE or 3D FSE combined with iMSDE preparation can achieve this high isotropic resolution and even resolve small nerve branches [2][3][4][5][6]; however, high-resolution 3D MRN of the LSP area can be significantly affected by B0 and B1 inhomogeneities that frequently occur in this region. The sequence used for T2 mapping of LSP nerves in this study is similar to a recently developed sequence that was successfully applied to T2 mapping of thigh muscles in healthy subjects [8].…”

Section: Discussionmentioning

confidence: 99%

“…A modified B1-insensitive rotation (BIR-4) pulse was used for the T2 preparation to minimize the sensitivity to B0 and B1 inhomogeneities (supplementary material) [8]. The parameters for the T2 mapping sequence were as follows: field of view (FOV) 38 × 38 × 8 cm 3 , acquisition voxel 2 × 2 × 2 mm 3 , echo train length 80, T2 preparation durations of 20/40/60/80 ms, fat suppression spectral attenuated inversion recovery (SPAIR) and a scan duration of 6:48 min with a repetition time (TR) of 1.6 s and an effective echo time (TE) of the TSE shot of 15 ms. The flip angle train of the TSE readout was designed in order to achieve a constant signal plateau throughout 80% of the TSE shot duration for white matter [9].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

“…Most previous studies using high-resolution 3D MRN of plexus nerves have focused on qualitative assessments of T2-weighted signal alterations while quantitative investigations are still mostly lacking [2][3][4][5][6]. Although increasing efforts are being made to further improve image quality, evaluation of nerves solely based on qualitative imaging remains challenging.…”

Section: Introductionmentioning

confidence: 99%

“…Especially isotropic high-resolution three-dimensional (3D) MRN has been repeatedly used in recent years to depict even small and highly oblique nerves of the brachial plexus or lumbosacral plexus (LSP) by allowing reformatting in multiple planes. In this context, 3D turbo spin echo (TSE) or 3D fast spin echo (FSE) are most commonly used for achieving isotropic high-resolution T2-weighted nerve imaging in or near a plexus [2][3][4]. Furthermore, fat-suppressed 3D TSE imaging has recently been combined with the improved motion sensitized driven equilibrium (iMSDE) preparation to suppress vessel signal and improve plexus nerve delineation [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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High Isotropic Resolution T2 Mapping of the Lumbosacral Plexus with T2-Prepared 3D Turbo Spin Echo

et al. 2018

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Purpose Isotropic high-resolution three-dimensional (3D) magnetic resonance neurography (MRN) is increasingly used to depict even small and highly oblique nerves of the lumbosacral plexus (LSP). The present study introduces a T2 mapping sequence (T2-prepared 3D turbo spin echo) that is B1-insensitive and enables quantitative assessment of LSP nerves. Methods In this study 15 healthy subjects (mean age 28.5 ± 3.8 years) underwent 3 T MRN of the LSP area three times. The T2 values were calculated offline on a voxel-by-voxel basis and measured at three segments (preganglionic, ganglionic, postganglionic) of three LSP nerves (S1, L5, L4) by two independent investigators (experienced and novice). Normative data for the different nerves were extracted and intraclass correlation coefficients (ICCs) were calculated to assess reproducibility and interobserver reliability of T2 measurements. Results The T2 mapping showed excellent reproducibility with ICCs ranging between 0.99 (S1 preganglionic) and 0.89 (L5 postganglionic). Interobserver reliability was less robust with ICCs ranging between 0.78 (S1 preganglionic) and 0.44 (L5 postganglionic) for S1 and L5. A mean T2 value of 74.6 ± 4.7 ms was registered for preganglionic segments, 84.7 ± 4.1 ms for ganglionic and 65.4 ± 2.5 ms for postganglionic segments, respectively. There was a statistically significant variation of T2 values across the nerve (preganglionic vs ganglionic vs postganglionic) for S1, L5, and L4. Conclusion Our approach enables isotropic high-resolution and B1-insensitive T2 mapping of LSP nerves with excellent reproducibility. It might reflect a robust and clinically useful method for future diagnostics of LSP pathologies.

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Section: Discussionmentioning

confidence: 99%

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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High Isotropic Resolution T2 Mapping of the Lumbosacral Plexus with T2-Prepared 3D Turbo Spin Echo

et al. 2018

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“…MRI is the modality of choice for depicting plexus injuries and nerve root avulsions which can be associated with dural laceration [30,31]. For this purpose MR neurography shows first promising results [32,33]. Using CT or MR myelography with adjunction of intrathecal contrast medium loss of CSF can directly be detected [7,34,35].…”

Section: Spinal Imagingmentioning

confidence: 99%

Undetected Dural Leaks Complicated by Accidental Drainage of Cerebrospinal Fluid (CSF) can Lead to Severe Neurological Deficits

Sporns¹,

Schwindt²,

Cnyrim³

et al. 2016

Fortschr Röntgenstr

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Purpose: Intracranial hypotension has been reported as a complication of accidental drainage after surgical treatment in several cases. Application of negative pressure systems (wound drains, VAC?-therapy, chest tube drainage) had typically led to severe intracranial hypotension including intracranial hemorrhage and tonsillar herniation. In the last year the authors observed 2 cases of accidental spinal drainage of CSF in patients with neurological deficits, regressing after reduction of the device suction. Material and Methods: We conducted a systematic PubMed-based research of the literature to study the variety and frequency of the reported symptoms from 1st of January 1980 until 1st of October 2015. Results: Reviewing the literature 24 relevant citations including 27 reported cases of posttraumatic or postoperative loss of CSF leading to neurological symptoms were identified. All 15 reported cases in which a negative pressure suction device had been applied showed severe neurological and radiological symptoms such as coma or brain herniation and intracranial hemorrhage. In all cases patients recovered rapidly after removal of the suction device. Milder symptoms were observed in the patients without negative pressure suction, mainly only presenting with headaches or cranial nerve involvement. Additionally, we give an overview about current recommendations regarding cranial and spinal imaging to rule out dural laceration and cranial hypotension. Conclusion: Patients with dural laceration complicated by accidental drainage of CSF can present with life-threatening conditions. Increasing use of negative pressure suction devices makes the reported condition an important differential diagnosis. A precise radiological examination can help to rule out dural laceration and intracranial hypotension. Key Points: ??Undetected dural laceration complicated by negative pressure suction drains can induce life-threatening symptoms. ??Increasing use of negative pressure suction devices makes the reported condition an important differential diagnosis for radiologists Citation Format: ??Sporns PB, Schwindt W, Cnyrim CD et?al. Undetected Dural Leaks Complicated by Accidental Drainage of Cerebrospinal Fluid (CSF) can Lead to Severe Neurological Deficits. Fortschr R?ntgenstr 2016; 188: 451???458

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Reconstruction magnetic resonance neurography in chronic inflammatory demyelinating polyneuropathy

Shibuya

Sugiyama

Ito

et al. 2014

Annals of Neurology

103

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To study distribution and patterns of nerve hypertrophy in chronic inflammatory demyelinating polyneuropathy (CIDP), magnetic resonance neurography with 3-dimensional reconstruction of short tau inversion recovery images was performed in 33 patients. This technique clearly showed longitudinal morphological changes from the cervical roots to the nerve trunks in the proximal arm. Nerve enlargement was detected in 88% of the patients. According to the clinical subtype of CIDP, typical CIDP patients showed symmetric and root-dominant hypertrophy, whereas Lewis-Sumner syndrome patients had multifocal fusiform hypertrophy in the nerve trunks. The patterns of nerve hypertrophy presumably reflect the different pathophysiology of each CIDP subtype.

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High-Resolution 3T MR Neurography of the Brachial Plexus and Its Branches, with Emphasis on 3D Imaging

Cited by 127 publications

References 32 publications

High Isotropic Resolution T2 Mapping of the Lumbosacral Plexus with T2-Prepared 3D Turbo Spin Echo

High Isotropic Resolution T2 Mapping of the Lumbosacral Plexus with T2-Prepared 3D Turbo Spin Echo

Undetected Dural Leaks Complicated by Accidental Drainage of Cerebrospinal Fluid (CSF) can Lead to Severe Neurological Deficits

Reconstruction magnetic resonance neurography in chronic inflammatory demyelinating polyneuropathy

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