MR neurography of brachial plexus at 3.0 T with robust fat and blood suppression

Xinzeng Wang, Crystal Harrison, Yogesh K. Mariappan, Karthik Gopalakrishnan, Avneesh Chhabra, Robert E. Lenkinski, Ananth J. Madhuranthakam

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Purpose: To develop and evaluate magnetic resonance (MR) neurography of the brachial plexus with robust fat and blood suppression for increased conspicuity of nerves at 3.0 T in clinically feasible acquisition times. Materials and Methods: This prospective study was HIPAA compliant, with institutional review board approval and written informed consent. A low-refocusing-flip-angle three-dimensional (3D) turbo spin-echo (TSE) sequence was modified to acquire both in-phase and out-of-phase echoes, required for chemical shift (Dixon) reconstruction, in the same repetition by using partial echoes combined with modified homodyne reconstruction with phase preservation. This multiecho TSE modified Dixon (mDixon) sequence was optimized by using simulations and phantom studies and in three healthy volunteers. The sequence was tested in five healthy volunteers and was evaluated in 10 patients who had been referred for brachial plexopathy at 3.0 T. The images were evaluated against the current standard of care, images acquired with a 3D TSE short inversion time inversion recovery (STIR) sequence, qualitatively by using the Wilcoxon signed-rank test and quantitatively by using the Friedman two-way analysis of variance, with P <.05 considered to indicate a statistically significant difference. Results: Multiecho TSE-mDixon involving partial-echo and homodyne reconstruction with phase preservation achieved uniform fat suppression in half the imaging time compared with multiacquisition TSE-mDixon. Compared with 3D TSE STIR, fat suppression, venous suppression, and nerve visualization were significantly improved (P < .05), while arterial suppression was better but not significantly so (P = .06), with increased apparent signal-to-noise ratio in the dorsal nerve root ganglion and C6 nerve (P <.001) with the multiecho TSE-mDixon sequence. Conclusion: The multiecho 3D TSE-mDixon sequence provides robust fat and blood suppression, resulting in increased conspicuity of the nerves, in clinically feasible imaging times and can be used for MR neurography of the brachial plexus at 3.0 T.

Original languageEnglish (US)
Pages (from-to)538-546
Number of pages9
JournalRadiology
Volume283
Issue number2
DOIs
StatePublished - May 1 2017

Fingerprint

Brachial Plexus
Magnetic Resonance Spectroscopy
Fats
Healthy Volunteers
Brachial Plexus Neuropathies
Sequence Inversion
Health Insurance Portability and Accountability Act
Research Ethics Committees
Spinal Ganglia
Signal-To-Noise Ratio
Standard of Care
Nonparametric Statistics
Informed Consent
Analysis of Variance
Prospective Studies

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

MR neurography of brachial plexus at 3.0 T with robust fat and blood suppression. / Wang, Xinzeng; Harrison, Crystal; Mariappan, Yogesh K.; Gopalakrishnan, Karthik; Chhabra, Avneesh; Lenkinski, Robert E.; Madhuranthakam, Ananth J.

In: Radiology, Vol. 283, No. 2, 01.05.2017, p. 538-546.

Research output: Contribution to journalArticle

Wang, X, Harrison, C, Mariappan, YK, Gopalakrishnan, K, Chhabra, A, Lenkinski, RE & Madhuranthakam, AJ 2017, 'MR neurography of brachial plexus at 3.0 T with robust fat and blood suppression', Radiology, vol. 283, no. 2, pp. 538-546. https://doi.org/10.1148/radiol.2016152842
Wang X, Harrison C, Mariappan YK, Gopalakrishnan K, Chhabra A, Lenkinski RE et al. MR neurography of brachial plexus at 3.0 T with robust fat and blood suppression. Radiology. 2017 May 1;283(2):538-546. https://doi.org/10.1148/radiol.2016152842
Wang, Xinzeng ; Harrison, Crystal ; Mariappan, Yogesh K. ; Gopalakrishnan, Karthik ; Chhabra, Avneesh ; Lenkinski, Robert E. ; Madhuranthakam, Ananth J. / MR neurography of brachial plexus at 3.0 T with robust fat and blood suppression. In: Radiology. 2017 ; Vol. 283, No. 2. pp. 538-546.
@article{142a05389519487f9c33485b01a86c31,
title = "MR neurography of brachial plexus at 3.0 T with robust fat and blood suppression",
abstract = "Purpose: To develop and evaluate magnetic resonance (MR) neurography of the brachial plexus with robust fat and blood suppression for increased conspicuity of nerves at 3.0 T in clinically feasible acquisition times. Materials and Methods: This prospective study was HIPAA compliant, with institutional review board approval and written informed consent. A low-refocusing-flip-angle three-dimensional (3D) turbo spin-echo (TSE) sequence was modified to acquire both in-phase and out-of-phase echoes, required for chemical shift (Dixon) reconstruction, in the same repetition by using partial echoes combined with modified homodyne reconstruction with phase preservation. This multiecho TSE modified Dixon (mDixon) sequence was optimized by using simulations and phantom studies and in three healthy volunteers. The sequence was tested in five healthy volunteers and was evaluated in 10 patients who had been referred for brachial plexopathy at 3.0 T. The images were evaluated against the current standard of care, images acquired with a 3D TSE short inversion time inversion recovery (STIR) sequence, qualitatively by using the Wilcoxon signed-rank test and quantitatively by using the Friedman two-way analysis of variance, with P <.05 considered to indicate a statistically significant difference. Results: Multiecho TSE-mDixon involving partial-echo and homodyne reconstruction with phase preservation achieved uniform fat suppression in half the imaging time compared with multiacquisition TSE-mDixon. Compared with 3D TSE STIR, fat suppression, venous suppression, and nerve visualization were significantly improved (P < .05), while arterial suppression was better but not significantly so (P = .06), with increased apparent signal-to-noise ratio in the dorsal nerve root ganglion and C6 nerve (P <.001) with the multiecho TSE-mDixon sequence. Conclusion: The multiecho 3D TSE-mDixon sequence provides robust fat and blood suppression, resulting in increased conspicuity of the nerves, in clinically feasible imaging times and can be used for MR neurography of the brachial plexus at 3.0 T.",
author = "Xinzeng Wang and Crystal Harrison and Mariappan, {Yogesh K.} and Karthik Gopalakrishnan and Avneesh Chhabra and Lenkinski, {Robert E.} and Madhuranthakam, {Ananth J.}",
year = "2017",
month = "5",
day = "1",
doi = "10.1148/radiol.2016152842",
language = "English (US)",
volume = "283",
pages = "538--546",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "2",

}

TY - JOUR

T1 - MR neurography of brachial plexus at 3.0 T with robust fat and blood suppression

AU - Wang, Xinzeng

AU - Harrison, Crystal

AU - Mariappan, Yogesh K.

AU - Gopalakrishnan, Karthik

AU - Chhabra, Avneesh

AU - Lenkinski, Robert E.

AU - Madhuranthakam, Ananth J.

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Purpose: To develop and evaluate magnetic resonance (MR) neurography of the brachial plexus with robust fat and blood suppression for increased conspicuity of nerves at 3.0 T in clinically feasible acquisition times. Materials and Methods: This prospective study was HIPAA compliant, with institutional review board approval and written informed consent. A low-refocusing-flip-angle three-dimensional (3D) turbo spin-echo (TSE) sequence was modified to acquire both in-phase and out-of-phase echoes, required for chemical shift (Dixon) reconstruction, in the same repetition by using partial echoes combined with modified homodyne reconstruction with phase preservation. This multiecho TSE modified Dixon (mDixon) sequence was optimized by using simulations and phantom studies and in three healthy volunteers. The sequence was tested in five healthy volunteers and was evaluated in 10 patients who had been referred for brachial plexopathy at 3.0 T. The images were evaluated against the current standard of care, images acquired with a 3D TSE short inversion time inversion recovery (STIR) sequence, qualitatively by using the Wilcoxon signed-rank test and quantitatively by using the Friedman two-way analysis of variance, with P <.05 considered to indicate a statistically significant difference. Results: Multiecho TSE-mDixon involving partial-echo and homodyne reconstruction with phase preservation achieved uniform fat suppression in half the imaging time compared with multiacquisition TSE-mDixon. Compared with 3D TSE STIR, fat suppression, venous suppression, and nerve visualization were significantly improved (P < .05), while arterial suppression was better but not significantly so (P = .06), with increased apparent signal-to-noise ratio in the dorsal nerve root ganglion and C6 nerve (P <.001) with the multiecho TSE-mDixon sequence. Conclusion: The multiecho 3D TSE-mDixon sequence provides robust fat and blood suppression, resulting in increased conspicuity of the nerves, in clinically feasible imaging times and can be used for MR neurography of the brachial plexus at 3.0 T.

AB - Purpose: To develop and evaluate magnetic resonance (MR) neurography of the brachial plexus with robust fat and blood suppression for increased conspicuity of nerves at 3.0 T in clinically feasible acquisition times. Materials and Methods: This prospective study was HIPAA compliant, with institutional review board approval and written informed consent. A low-refocusing-flip-angle three-dimensional (3D) turbo spin-echo (TSE) sequence was modified to acquire both in-phase and out-of-phase echoes, required for chemical shift (Dixon) reconstruction, in the same repetition by using partial echoes combined with modified homodyne reconstruction with phase preservation. This multiecho TSE modified Dixon (mDixon) sequence was optimized by using simulations and phantom studies and in three healthy volunteers. The sequence was tested in five healthy volunteers and was evaluated in 10 patients who had been referred for brachial plexopathy at 3.0 T. The images were evaluated against the current standard of care, images acquired with a 3D TSE short inversion time inversion recovery (STIR) sequence, qualitatively by using the Wilcoxon signed-rank test and quantitatively by using the Friedman two-way analysis of variance, with P <.05 considered to indicate a statistically significant difference. Results: Multiecho TSE-mDixon involving partial-echo and homodyne reconstruction with phase preservation achieved uniform fat suppression in half the imaging time compared with multiacquisition TSE-mDixon. Compared with 3D TSE STIR, fat suppression, venous suppression, and nerve visualization were significantly improved (P < .05), while arterial suppression was better but not significantly so (P = .06), with increased apparent signal-to-noise ratio in the dorsal nerve root ganglion and C6 nerve (P <.001) with the multiecho TSE-mDixon sequence. Conclusion: The multiecho 3D TSE-mDixon sequence provides robust fat and blood suppression, resulting in increased conspicuity of the nerves, in clinically feasible imaging times and can be used for MR neurography of the brachial plexus at 3.0 T.

UR - http://www.scopus.com/inward/record.url?scp=85018465977&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85018465977&partnerID=8YFLogxK

U2 - 10.1148/radiol.2016152842

DO - 10.1148/radiol.2016152842

M3 - Article

C2 - 28005489

AN - SCOPUS:85018465977

VL - 283

SP - 538

EP - 546

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 2

ER -