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J Magn Reson Imaging. 2016 Mar;43(3):644-54. doi: 10.1002/jmri.25025. Epub 2015 Aug 6.

Diffusion-prepared neurography of the brachial plexus with a large field-of-view at 3T.

Author information

1
Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.
2
Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Nijmegen, The Netherlands.
3
Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, The Netherlands.
4
Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands.
5
Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
6
Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands.

Abstract

PURPOSE:

To study diffusion-prepared neurography optimized for a large field-of-view (FOV) to include the neck and both shoulders. In a large FOV poor homogeneity of the magnetic field (B0 ) often leads to poor image quality and possibly to poor diagnostic accuracy. The aim was therefore to find an optimal (combination of) shimming method(s) for diffusion-prepared neurography in a large FOV.

MATERIALS AND METHODS:

A 3D diffusion-prepared sequence with a large FOV was tested with and without the use of a susceptibility-matched pillow combined with image-based (IB) or standard shimming in six healthy volunteers on a 3T system. B0 , B1 , signal to noise ratio (SNR), and contrast to noise ratio (CNR) were compared between all protocols. Additionally, nerve visibility, fat suppression, artifacts, and overall image quality were ordinally (5-point scale) assessed by two readers. Furthermore, correlations between B0 and B1 (offset and variation) and SNR, CNR, and image quality were explored.

RESULTS:

The use of the susceptibility-matched pillow led to a 43% reduction of B0 variation over the brachial plexus compared to the situation without a pillow (P < 0.05). The combination of the pillow with IB-shimming and the optimized diffusion-prepared sequence resulted in good nerve visibility, good fat suppression, no artifacts that would hinder clinical diagnosis, and a good overall quality (median scores ≥4). Reducing B0 variation was associated with SNR, CNR, and the above-mentioned scored features (P < 0.05).

CONCLUSION:

The use of a susceptibility-matched pillow in combination with IB-shimming enables robust and high-quality neurography of the complete brachial plexus.

KEYWORDS:

3D turbo spin-echo; MR neurography; brachial plexus; magnetic susceptibility; peripheral nerves; shimming

PMID:
26251015
DOI:
10.1002/jmri.25025
[Indexed for MEDLINE]

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