Brachial Plexus Magnetic Resonance Neurography: Technical Challenges and Solutions

Area of Science:

• Radiology
• Neuroimaging
• Magnetic Resonance Imaging

Background:

• Brachial plexus (BP) magnetic resonance neurography (MRN) presents significant anatomical and technical challenges.
• Improving image quality is crucial for accurate diagnosis and treatment planning.

Purpose of the Study:

• To outline optimized magnetic resonance (MR) techniques for enhanced brachial plexus neurography.
• To improve nerve conspicuity and reduce artifacts in BP MRN.

Main Methods:

• Utilizing 3.0 Telsa (T) scanners with unilateral imaging protocols.
• Employing optimized surface coil selection and placement.
• Implementing advanced pulse sequences including fat, vascular, and respiratory artifact suppression, and metal artifact reduction techniques.
• Leveraging 3-dimensional (3D) imaging sequences.

Main Results:

• Optimized techniques significantly increase the nerve-to-background contrast ratio.
• Effective mitigation of common imaging artifacts (e.g., fat, vascular, respiratory, metal).
• Demonstrated improvement in image quality and diagnostic confidence for brachial plexus visualization.

Conclusions:

• Specific optimization of MR techniques is essential for high-quality brachial plexus neurography.
• Improved imaging facilitates more confident nonoperative and operative management decisions.
• Advanced MRN techniques enhance diagnostic capabilities for brachial plexus pathologies.