3D MR Neurography of the Lumbosacral Plexus: Obtaining Optimal Images for Selective Longitudinal Nerve Depiction

Sims, G. Cho; Boothe, Ethan; Joodi, Robert; Chhabra, Avneesh

doi:10.3174/ajnr.a4879

Cited by 23 publications

(20 citation statements)

References 14 publications

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“…It has been demonstrated recently that 3D TSE or 3D FSE combined with iMSDE preparation can achieve this high isotropic resolution and even resolve small nerve branches [2][3][4][5][6]; however, high-resolution 3D MRN of the LSP area can be significantly affected by B0 and B1 inhomogeneities that frequently occur in this region. The sequence used for T2 mapping of LSP nerves in this study is similar to a recently developed sequence that was successfully applied to T2 mapping of thigh muscles in healthy subjects [8].…”

Section: Discussionmentioning

confidence: 99%

“…Frequent pathologies for K which quantitative measurements could be regarded as helpful during diagnostics and monitoring might be demyelinating polyneuropathies or structural abnormalities leading to compression of nerves, such as disc protrusion or spinal stenosis [6,15,16]. Additionally, adding quantitative measurements to mere nerve visualization during high-resolution MRN might further enhance guidance of interventional nerve blocks and perineural injections.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding quantitative approaches, diffusion imaging has been used to outline normative values and microstructural organization of LSP nerves [12][13][14]. Furthermore, an iMSDE-prepared sequence for 3D imaging has been used to measure sciatic and femoral nerve angles and diameters in healthy subjects, and the obtained values might serve as normative data for comparison to patients with pathologies affecting the LSP [6].…”

Section: Discussionmentioning

confidence: 99%

“…Most previous studies using high-resolution 3D MRN of plexus nerves have focused on qualitative assessments of T2-weighted signal alterations while quantitative investigations are still mostly lacking [2][3][4][5][6]. Although increasing efforts are being made to further improve image quality, evaluation of nerves solely based on qualitative imaging remains challenging.…”

Section: Introductionmentioning

confidence: 99%

“…In this context, 3D turbo spin echo (TSE) or 3D fast spin echo (FSE) are most commonly used for achieving isotropic high-resolution T2-weighted nerve imaging in or near a plexus [2][3][4]. Furthermore, fat-suppressed 3D TSE imaging has recently been combined with the improved motion sensitized driven equilibrium (iMSDE) preparation to suppress vessel signal and improve plexus nerve delineation [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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High Isotropic Resolution T2 Mapping of the Lumbosacral Plexus with T2-Prepared 3D Turbo Spin Echo

et al. 2018

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Purpose Isotropic high-resolution three-dimensional (3D) magnetic resonance neurography (MRN) is increasingly used to depict even small and highly oblique nerves of the lumbosacral plexus (LSP). The present study introduces a T2 mapping sequence (T2-prepared 3D turbo spin echo) that is B1-insensitive and enables quantitative assessment of LSP nerves. Methods In this study 15 healthy subjects (mean age 28.5 ± 3.8 years) underwent 3 T MRN of the LSP area three times. The T2 values were calculated offline on a voxel-by-voxel basis and measured at three segments (preganglionic, ganglionic, postganglionic) of three LSP nerves (S1, L5, L4) by two independent investigators (experienced and novice). Normative data for the different nerves were extracted and intraclass correlation coefficients (ICCs) were calculated to assess reproducibility and interobserver reliability of T2 measurements. Results The T2 mapping showed excellent reproducibility with ICCs ranging between 0.99 (S1 preganglionic) and 0.89 (L5 postganglionic). Interobserver reliability was less robust with ICCs ranging between 0.78 (S1 preganglionic) and 0.44 (L5 postganglionic) for S1 and L5. A mean T2 value of 74.6 ± 4.7 ms was registered for preganglionic segments, 84.7 ± 4.1 ms for ganglionic and 65.4 ± 2.5 ms for postganglionic segments, respectively. There was a statistically significant variation of T2 values across the nerve (preganglionic vs ganglionic vs postganglionic) for S1, L5, and L4. Conclusion Our approach enables isotropic high-resolution and B1-insensitive T2 mapping of LSP nerves with excellent reproducibility. It might reflect a robust and clinically useful method for future diagnostics of LSP pathologies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

High Isotropic Resolution T2 Mapping of the Lumbosacral Plexus with T2-Prepared 3D Turbo Spin Echo

et al. 2018

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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

Cervantes

Kirschke

Klupp

et al. 2017

Magnetic Resonance in Med

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Purpose: To design a preparation module for vessel signal suppression in MR neurography of the extremities, which causes minimal attenuation of nerve signal and is highly insensitive to eddy currents and motion. Methods: The orthogonally combined motion-and diffusionsensitized driven equilibrium (OC-MDSDE) preparation was proposed, based on the improved motion-and diffusionsensitized driven equilibrium methods (iMSDE and FC-DSDE, respectively), with specific gradient design and orientation. OC-MDSDE was desensitized against eddy currents using appropriately designed gradient prepulses. The motion sensitivity and vessel signal suppression capability of OC-MDSDE and its components were assessed in vivo in the knee using 3D turbo spin echo (TSE). Nerve-to-vessel signal ratios were measured for iMSDE and OC-MDSDE in 7 subjects. Results: iMSDE was shown to be highly sensitive to motion with increasing flow sensitization. FC-DSDE showed robustness against motion, but resulted in strong nerve signal loss with diffusion gradients oriented parallel to the nerve. OC-MDSDE showed superior vessel suppression compared to iMSDE and FC-DSDE and maintained high nerve signal. Mean nerve-to-vessel signal ratios in 7 subjects were 0.40 6 0.17 for iMSDE and 0.63 6 0.37 for OC-MDSDE. Conclusion: OC-MDSDE combined with 3D TSE in the extremities allows high-near-isotropic-resolution imaging of peripheral nerves with reduced vessel contamination and high nerve signal. Magn Reson Med 79:407-415, 2018. V C 2017 Wiley Periodicals, Inc.

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Isotropic resolution diffusion tensor imaging of lumbosacral and sciatic nerves using a phase‐corrected diffusion‐prepared 3D turbo spin echo

Cervantes

Van

Weidlich

et al. 2018

Magnetic Resonance in Med

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PurposeTo perform in vivo isotropic‐resolution diffusion tensor imaging (DTI) of lumbosacral and sciatic nerves with a phase‐navigated diffusion‐prepared (DP) 3D turbo spin echo (TSE) acquisition and modified reconstruction incorporating intershot phase‐error correction and to investigate the improvement on image quality and diffusion quantification with the proposed phase correction.MethodsPhase‐navigated DP 3D TSE included magnitude stabilizers to minimize motion and eddy‐current effects on the signal magnitude. Phase navigation of motion‐induced phase errors was introduced before readout in 3D TSE. DTI of lower back nerves was performed in vivo using 3D TSE and single‐shot echo planar imaging (ss‐EPI) in 13 subjects. Diffusion data were phase‐corrected per k z plane with respect to T2‐weighted data. The effects of motion‐induced phase errors on DTI quantification was assessed for 3D TSE and compared with ss‐EPI.ResultsNon–phase‐corrected 3D TSE resulted in artifacts in diffusion‐weighted images and overestimated DTI parameters in the sciatic nerve (mean diffusivity [MD] = 2.06 ± 0.45). Phase correction of 3D TSE DTI data resulted in reductions in all DTI parameters (MD = 1.73 ± 0.26) of statistical significance (P ≤ 0.001) and in closer agreement with ss‐EPI DTI parameters (MD = 1.62 ± 0.21).ConclusionDP 3D TSE with phase correction allows distortion‐free isotropic diffusion imaging of lower back nerves with robustness to motion‐induced artifacts and DTI quantification errors. Magn Reson Med 80:609–618, 2018. © 2018 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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3D MR Neurography of the Lumbosacral Plexus: Obtaining Optimal Images for Selective Longitudinal Nerve Depiction

Abstract: Angular lumbosacral plexus measurements aid in the prescription of different planes on MR imaging for the optimal longitudinal demonstration of nerves.

Cited by 23 publications

References 14 publications

High Isotropic Resolution T2 Mapping of the Lumbosacral Plexus with T2-Prepared 3D Turbo Spin Echo

High Isotropic Resolution T2 Mapping of the Lumbosacral Plexus with T2-Prepared 3D Turbo Spin Echo

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

Isotropic resolution diffusion tensor imaging of lumbosacral and sciatic nerves using a phase‐corrected diffusion‐prepared 3D turbo spin echo

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