Technological Advancements in Magnetic Resonance Neurography
- 166 Downloads
Purpose of Review
Magnetic resonance neurography (MRN) is being increasingly used as a problem-solving tool for diagnosis and management of peripheral neuropathies. This review is aimed at summarizing important technological advances, including MR pulse sequence and surface coil developments, which have facilitated MRN’s use in clinical practice.
The most recent research in MRN focuses on its clinical applications, with concomitant development of three-dimensional, parallel imaging and vascular suppression techniques that facilitate higher spatial resolution and depiction of small nerve branches arising from the brachial and lumbosacral plexi as well as fascicular abnormalities of more distal extremity nerves. Quantitative diffusion tensor imaging (DTI) has been studied as a tool to detect microstructural abnormalities of peripheral nerves and more precisely define grades of nerve injury but will require additional investigation to determine its role in daily clinical practice.
MRN continues to evolve due to technological improvements and awareness by the medical community of its capabilities. Additional technological developments related to surface coil designs and vascular suppression techniques will be needed to move the field forward.
KeywordsMR neurography Peripheral nerve MRI Peripheral nerve DTI
The authors would like to thank Drs. Fraser Robb and Yun-Jeong Stickle from GE Healthcare, Inc., in Aurora, OH, for designing and building the 64-channel prototype brachial plexus coil mentioned in this article.
Compliance with Ethical Standards
Conflict of Interest
Darryl B. Sneag and Sophie Queler report the Hospital for Special Surgery has an institutional research agreement with GE Healthcare.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 2.Heinen C, Dömer P, Schmidt T, Kewitz B, Janssen-Biehnhold U, Kretschmer T. Fascicular ratio pilot study: high-resolution neurosonography-a possible tool for quantitative assessment of traumatic peripheral nerve lesions before and after nerve surgery. Neurosurgery. 2018;85:415–422.CrossRefGoogle Scholar
- 5.• Sneag DB, Rancy SK, Wolfe SW, Lee SC, Kalia V, Lee SK, et al. Brachial plexitis or neuritis? MRI features of lesion distribution in parsonage-turner syndrome. Muscle Nerve. 2018;58:359–66 This study demonstrates that the prevailing imaging findings in Parsonage-Turner syndrome are intrinsic constrictions of peripheral nerves distal to the brachial plexus proper. CrossRefGoogle Scholar
- 11.• Cervantes B, Kirschke JS, Klupp E, Kooijman H, Börnert P, Haase A, et al. Orthogonally combined motion- and diffusion-sensitized driven equilibrium (OC-MDSDE) preparation for vessel signal suppression in 3D turbo spin echo imaging of peripheral nerves in the extremities. Magn Reson Med. 2017;79:407–15 This article describes a non-contrast technique for vascular suppression in MRN. CrossRefGoogle Scholar
- 15.Sneag DB, Curlin J, Shin J, Fung M, Lin B, Daniels SP. High-resolution brachial plexus imaging using 3-D short tau inversion recovery (CUBESTIR) with IV gadolinium for vascular suppression. International Society for Magnetic Resonance in Medicine Annual Meeting. May 14, 2019.Google Scholar
- 18.Shah P, Argentieri E, Koff MF, Sneag DB. Quantitative evaluation of T2 signal intensity for the assessment of muscle denervation. ISMRM 25th Scientific Meeting & Exhibition. Honolulu, HI. April 22–27, 2017.Google Scholar
- 25.Shin J, Curlin J, Tan ET, Fung M, Sneag DB. Denoising of diffusion MRI improves peripheral nerve conspicuity and reproducibility. International Society for Magnetic Resonance in Medicine Annual Meeting. Montreal, Canada. May 13, 2019.Google Scholar