The Application of Contrast-Enhanced 3D-STIR-VISTA MR Imaging of the Brachial Plexus

Abstract

Objective: To introduce contrast-enhanced 3D-STIR-VISTA sequence that would improve the image quality for the brachial plexus imaging and enhance the contrast between the brachial plexus and surrounding tissues. Methods: Thirty subjects (average age, 47.33 ± 15.15 years; 22 males and 8 females) were enrolled, including 7 patients with brachial plexus injuries, 4 patients with schwannomas, 1 patient with neurofibroma, 1 patient with thoracic outlet syndrome, 1 patient with metastasis, 1 patient with brachial plexus neuritis, and 15 patients without abnormal findings. Scores of unenhanced and contrast-enhanced 3D-STIR-VISTA images using a 5-point scale were compared by Wilcoxon’s signed-rank test. The signal intensity (SI), signal to noise ratio (SNR), contrast to noise ratio (CNR) and contrast ratio (CR) between 3D-STIR-VISTA images without and with contrast agent were compared by the paired Student t-test. Results: The SNRs of the brachial plexus between 3D-STIR-VISTA without and with contrast agent were not significantly different, while SNRs of surrounding tissues were significantly decreased with contrast agent. The CNRs of 3D-STIR-VISTA images with contrast agent were significantly higher than that without contrast agent. The 3D-STIR-VISTA sequence with contrast agent exhibited a statistically higher CR than that without contrast agent. The average score for 3D-STIR-VISTA images with contrast agent was significantly higher than that without contrast agent. Conclusion: The 3D-STIR-VISTA sequence with contrast agent is qualitatively and quantitatively superior to that without a contrast agent. The contrast-enhanced 3D-STIR-VISTA sequence can provide distinct visualization of the brachial plexus and enhance the contrast between the brachial plexus and surrounding tissues.

The guiding value of the cinematic volume rendering technique in the preoperative diagnosis of brachial plexus schwannoma

“…Brachial plexus imaging can accurately describe the imaging characteristics of brachial plexus schwannomas, including the lesion size, location, source, and surrounding tissue involvement, to guide surgical methods and evaluate resectability ( 9 , 10 ). The 3D-STIR-SPACE sequence can display the structures of the brachial plexus by inhibiting background fat, which helps to diagnose the location, origin, and extent of the brachial plexus schwannoma ( 11 – 13 ). Additionally, it can be reconstructed in three dimensions through post-processing to clearly show the spatial relationship between the tumor and the brachial plexus.…”