Three-dimensional MR Neurography of the Brachial Plexus: Vascular Suppression with                     Low-dose Ferumoxytol

Pedrick, Emily G; Sneag, Darryl B.; Colucci, Philip G.; Duong, MyLinh T.; Tan, Ek Tsoon

doi:10.1148/radiol.221087

Cited by 6 publications

(2 citation statements)

References 18 publications

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“…For instance, FE-MRA is capable of depicting deep venous thrombosis of the lower extremities, and is able to illustrate the extent of the thrombus even in the case of slow flow [ 13 ]. Furthermore, the suppression of minor venous blood signals through black-blood imaging can enhance nerve visualization, leading to increased diagnostic confidence [ 14 ] (Fig. 2 ).…”

Section: Ferumoxytol’s Characteristics In Mrimentioning

confidence: 99%

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Unveiling the next generation of MRI contrast agents: current insights and perspectives on ferumoxytol-enhanced MRI

Si,

Du,

Tang

et al. 2024

National Science Review

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Contrast-enhanced magnetic resonance imaging (CE-MRI) is a pivotal tool for global disease diagnosis and management. Since its clinical availability in 2009, the off-label use of ferumoxytol for ferumoxytol-enhanced MRI (FE-MRI) has significantly reshaped CE-MRI practices. Unlike MRI that's enhanced by gadolinium-based contrast agents, FE-MRI offers advantages such as reduced contrast agent dosage, extended imaging windows, no nephrotoxicity, higher MRI time efficiency, and the capability for molecular imaging. As a leading superparamagnetic iron oxide contrast agent, ferumoxytol is heralded as the next generation of contrast agents. This review delineates the pivotal clinical applications and inherent technical superiority of FE-MRI, providing an avant-garde medical-engineering interdisciplinary lens, thus bridging the gap between clinical demands and engineering innovations. Concurrently, we spotlight the emerging imaging themes and new technical breakthroughs. Lastly, we share our own insights on the potential trajectory of FE-MRI, shedding light on its future within the medical imaging realm.

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Section: Ferumoxytol’s Characteristics In Mrimentioning

confidence: 99%

Section: Ferumoxytol’s Characteristics In Mrimentioning

confidence: 99%

Unveiling the next generation of MRI contrast agents: current insights and perspectives on ferumoxytol-enhanced MRI

Si,

Du,

Tang

et al. 2024

National Science Review

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Magnetic resonance neurography in the diagnosis of neurological subtypes of thoracic outlet syndrome

Davidson,

Tan,

Sneag

2024

Muscle and Nerve

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Neurological thoracic outlet syndrome (TOS) can be challenging to diagnose, particularly given its described subtypes of neurogenic TOS (NTOS) and disputed TOS (DTOS) that exhibit variable clinical presentations and etiologies. The diagnostic workup of TOS often includes magnetic resonance neurography (MRN) of the brachial plexus. Specific MRN imaging modifications for TOS evaluation are required to maximize spatial and contrast resolution to increase the conspicuity of nerve segments and their relationships to surrounding osseous structures. Dynamic assessment with arm positioning is used to evaluate outlet narrowing and compression of the plexus. Individual nerve segments are interrogated for their longitudinal and cross‐sectional morphologies and signal characteristics. In patients with NTOS, MRN may reveal focal impingement of the C8/T1 nerve roots and/or lower trunk with accompanying abnormal T2‐weighted signal hyperintensity. Predisposing anatomical entities include cervical ribs, rib synostoses, hypertrophic callous following clavicular fracture, remnant first thoracic rib from prior incomplete resection, and variable perineural scarring. In comparison, DTOS patients frequently demonstrate signal hyperintensity and enlargement of the mid plexus (trunk and division level), with narrowing of the costoclavicular interval. Following comprehensive diagnostic workup that frequently includes electrodiagnostic testing, patients are directed to different management pathways. Nonsurgical management is considered for all cases of DTOS; all patients with NTOS or DTOS who fail conservative treatment warrant referral for a surgical opinion. If surgery is pursued, MRN can be helpful in preoperative planning.

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A neuromuscular clinician's guide to magnetic resonance neurography

Pitman,

Fayad,

Ahlawat

2024

Muscle and Nerve

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Magnetic resonance neurography (MRN) is increasingly used in clinical practice for the evaluation of patients with a wide spectrum of peripheral nerve disorders. This review article discusses the technical aspects of MRN highlighting the core sequences performed for clinical care. A robust, high‐resolution, heavily T2‐weighted fluid‐sensitive sequence performed on a 3.0 Tesla magnet system remains the main workhorse MRN sequence. In specific clinical scenarios, adjunct techniques such as diffusion‐weighted imaging can be added to a protocol for disease characterization. In addition, gadolinium‐based contrast material can also be administered for the purposes of image optimization (suppress adjacent vascular signal) and disease characterization. Technical modifications to field of view and planes of imaging can be made based on the clinical question and discussion with the radiologist(s). On fluid‐sensitive MRN sequences, a normal peripheral nerve exhibits iso‐ to minimally hyperintense signal relative to skeletal muscle with a predictable trajectory, preserved “fascicular” architecture, and tapered caliber from proximal to distal. Peripheral nerve abnormalities on MRN include alterations in signal, caliber, architecture, diffusion characteristics as well as enhancement and provide information regarding the underlying etiology. Although some MRN findings including nerve hyperintensity and long‐segmental enlargement are nonspecific, there are certain diagnoses that can be made with high certainty based on imaging including benign peripheral nerve tumors, high‐grade peripheral nerve injury, and intraneural ganglia. The purpose of this article is to familiarize a neuromuscular clinician with fundamentals of MRN acquisition and interpretation to facilitate communication with the neuromuscular radiologist and optimize patient care.

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Three-dimensional MR Neurography of the Brachial Plexus: Vascular Suppression with Low-dose Ferumoxytol

Cited by 6 publications

References 18 publications

Unveiling the next generation of MRI contrast agents: current insights and perspectives on ferumoxytol-enhanced MRI

Unveiling the next generation of MRI contrast agents: current insights and perspectives on ferumoxytol-enhanced MRI

Magnetic resonance neurography in the diagnosis of neurological subtypes of thoracic outlet syndrome

A neuromuscular clinician's guide to magnetic resonance neurography

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