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Combine contrast-enhanced 3D T2-weighted short inversion time inversion recovery MR neurography with MR angiography at 1.5 T in the assessment of brachial plexopathy

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Abstract

Purpose

To explore the benefits of using a single injection of contrast agent at a 1.5 T system to perform both contrast-enhanced MR angiography (MRA) and 3D-T2-STIR MR neurography (MRN) to assess of brachial plexopathy.

Methods

In this prospective study, 27 patients with suspected brachial plexopathy, received an imaging procedure composed sequentially of non-enhanced 3D-T2-STIR, CE-MRA, and contrast-enhanced 3D-T2-STIR, using a 1.5 T MR scanner. Signal intensities and contrast ratios were compared with and without contrast agent. The non-enhanced and contrast-enhanced 3D-T2-STIR images were mixed for two experienced radiologists to rate image diagnostic quality in a blind manner. 3D images of MRN and MRA were merged to reveal the spatial relation between brachial plexopathy and concomitant vascular disorders.

Results

By comparing the non-enhanced with contrast-enhanced 3D-T2-STIR images, it revealed that the use of the contrast agent in 3D-T2-STIR MRN could significantly suppress the background signals contributed by small vein (P < 0.001), lymph node (P < 0.001), muscle (P < 0.001) and bone (P < 0.001). This improved the contrast ratios between the brachial plexus and its surrounding tissues (P < 0.001) and boosted the image’s quality score (P < 0.01). Examining both CE-MRA and 3D-T2-STIR images revealed a relatively high incidence of concurrent vascular dysfunction in brachial plexopathy, with 39% of confirmed cases accompanied with subclavian and axillary vessel abnormalities.

Conclusion

Combining contrast-enhanced 3D-T2-STIR MRN with MRA at a 1.5 T system significantly suppresses background signals, improves brachial-plexus display, and provides a direct assessment for both brachial plexus lesion and surrounding vascular injury.

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Funding

This study was funded by Shanghai Key Laboratory for Peripheral Nerve and Microsurgery (17DZ2270500) and Zhangjiagang Bureau of Technology (ZKS1729).

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Authors and Affiliations

  1. Department of Radiology, The Affiliated Zhangjiagang Hospital of Soochow University, 68 Jiyang West Road, Zhangjiagang, 215600, Jiangsu, China

    Zhengdao Xu, Tonghua Zhang, Jianxin Chen, Yijiang Hu, Jiahui Zhang & Feifei Xue

  2. Department of Orthopedics, The Affiliated Zhangjiagang Hospital of Soochow University, 68 Jiyang West Road, Zhangjiagang, 215600, Jiangsu, China

    Zongbao Liu

  3. Department of Hand Surgery and Shanghai Key Laboratory for Peripheral Nerve and Microsurgery, Fudan University Huashan Hospital, 12 Wulumuqi Middle Road, Shanghai, 200040, China

    Tao Wang

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  1. Zhengdao Xu
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by ZX, TZ, JC, and ZL. Statistical analysis was performed by ZX, TZ. The first draft of the manuscript was written by ZX and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Zongbao Liu.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Xu, Z., Zhang, T., Chen, J. et al. Combine contrast-enhanced 3D T2-weighted short inversion time inversion recovery MR neurography with MR angiography at 1.5 T in the assessment of brachial plexopathy. Magn Reson Mater Phy 34, 229–239 (2021). https://doi.org/10.1007/s10334-020-00867-z

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