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European Radiology

, Volume 25, Issue 6, pp 1672–1677 | Cite as

SHINKEI—a novel 3D isotropic MR neurography technique: technical advantages over 3DIRTSE-based imaging

  • Jared M. Kasper
  • Vibhor Wadhwa
  • Kelly M. Scott
  • Shai Rozen
  • Yin Xi
  • Avneesh ChhabraEmail author
Magnetic Resonance

Abstract

Objectives

Technical assessment of SHINKEI pulse sequence and conventional 3DIRTSE for LS plexus MR neurography.

Methods

Twenty-one MR neurography examinations of the LS plexus were performed at 3 T, using 1.5-mm isotropic 3DIRTSE and SHINKEI sequences. Images were evaluated for motion and pulsation artefacts, nerve signal-to-noise ratio, contrast-to-noise ratio, nerve-to-fat ratio, muscle-to-fat ratio, fat suppression homogeneity and depiction of LS plexus branches. Paired Student t test was used to assess differences in nerve conspicuity (p < 0.05 was considered statistically significant). ICC correlation was obtained for intraobserver performance.

Results

Four examinations were excluded due to prior spine surgery. Bowel motion artefacts, pulsation artefacts, heterogeneous fat saturation and patient motion were seen in 16/17, 0/17, 17/17, 2/17 on 3DIRTSE and 0/17, 0/17, 0/17, 1/17 on SHINKEI. SHINKEI performed better (p < 0.01) for nerve signal-to-noise, contrast-to-noise, nerve-to-fat and muscle-to-fat ratios. 3DIRTSE and SHINKEI showed all LS plexus nerve roots, sciatic and femoral nerves. Smaller branches including obturator, lateral femoral cutaneous and iliohypogastric nerves were seen in 10/17, 5/17, 1/17 on 3DIRTSE and 17/17, 16/17, 7/17 on SHINKEI. Intraobserver reliability was excellent.

Conclusion

SHINKEI MRN demonstrates homogeneous and superior fat suppression with increased nerve signal- and contrast-to-noise ratios resulting in better conspicuity of smaller LS plexus branches.

Key Points

• SHINKEI provides homogeneous and superior fat suppression, shown by higher nerve and muscle-to-fat ratios.

• SHINKEI shows better nerve signal-to-noise and contrast-to-noise ratios than 3DIRTSE.

• SHINKEI enables nerve-selective images with increased conspicuity of smaller LS plexus branches.

• SHINKEI should be considered in routine MR neurography of the LS plexus.

Keywords

Magnetic resonance imaging SHINKEI MR Neurography LS plexus 

Abbreviations

3DIRTSE

three-dimensional inversion recovery turbo spin echo

DWI

diffusion-weighted imaging

iMSDE

improved Motion Sensitized Driven Equilibrium

SHINKEI

nerve-SHeath signal increased with INKed rest-tissue RARE Imaging

Notes

Acknowledgements

Thanks to Yoneyama M, Masaya Takahashi, Dwayne Isbell and Ivan Dimitrov for the MRI sequence support. The scientific guarantor of this publication is Avneesh Chhabra. The authors of this manuscript declare relationships with the following companies: Dr. Chhabra has received research grants from GE-AUR (GERRAF), Siemens Medical Solutions and Integra Life Sciences. He also serves as a research consultant with Siemens CAD group. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

Dr Chhabra has received research grants from GE-AUR (GERRAF), Siemens Medical Solutions, and Integra Life Sciences. He also serves as a research consultant with Siemens CAD group.

Supplementary material

Video 1

3DIRTSE of LS plexus (MPG 1530 kb)

Video 2

3D SHINKEI MPR of LS plexus (MPG 1814 kb)

Video 3

3D SHINKEI MIP of LS plexus (MPG 1764 kb)

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Copyright information

© European Society of Radiology 2015

Authors and Affiliations

  • Jared M. Kasper
    • 1
  • Vibhor Wadhwa
    • 1
  • Kelly M. Scott
    • 2
  • Shai Rozen
    • 3
  • Yin Xi
    • 1
  • Avneesh Chhabra
    • 1
    • 4
    Email author
  1. 1.Musculoskeletal RadiologyUniversity of Texas Southwestern Medical CenterDallasUSA
  2. 2.Physical Medicine and RehabilitationUniversity of Texas Southwestern Medical CenterDallasUSA
  3. 3.Plastic SurgeryUniversity of Texas Southwestern Medical CenterDallasUSA
  4. 4.Johns Hopkins UniversityBaltimoreUSA

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