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7 T Lumbosacral Plexus Neurography: Feasibility and Comparison of Spinal Nerve Visualization With 3 T MRI
Adrian A Marth1, Georg Constantin Feuerriegel, Florian Wanivenhaus
1From the Department of Radiology, Balgrist University Hospital, Zurich, Switzerland (A.A.M., G.C.F., R.S.); Swiss Center for Musculoskeletal Imaging, Balgrist Campus AG, Zurich, Switzerland (A.A.M., D.N.); Department of Orthopedic Surgery, Balgrist University Hospital, Zurich, Switzerland (F.W.); and Medical Faculty, University of Zurich, Zurich, Switzerland (D.N., R.S.).
Objectives:
7 T magnetic resonance (MR) imaging can offer superior spatial resolution compared with lower field strengths. However, its use for imaging of the lumbosacral plexus has been constrained by technical challenges and therefore remained relatively unexplored. Therefore, this study investigated the feasibility of 7 T MR neurography by means of comparing the visibility of the spinal nerves and image quality to 3 T MR neurography.
Materials And Methods:
In this monocentric, institutional review board-approved, prospective study, 30 healthy subjects underwent acquisition time-matched 7 T MR neurography and 3 T MR neurography of the lumbar spine using a 3-dimensional dual-echo steady-state sequence. Visibility of the nerve root, dorsal root ganglia, and spinal nerve fascicles of L1-S1, along with image artifacts and overall image quality, were compared between the different field strengths by 2 radiologists using 4-point Likert scales (1 = poor, 4 = excellent). Comparisons between field strengths were made using the Wilcoxon signed rank test, and interobserver agreement was assessed.
Results:
7 T MR neurography enabled significantly improved visualization of the lumbar nerve roots, dorsal root ganglia, and spinal nerve fascicles ( P ≤ 0.002). Compared with 3 T MR neurography, no difference in overall image quality was observed ( P = 0.211), although 7 T MR imaging exhibited significantly increased image artifacts ( P < 0.001). Interobserver agreement (κ) for qualitative measures ranged from 0.71 to 0.88 for 7 T, and from 0.75 to 0.91 for 3 T.
Conclusions:
7 T MR neurography allowed for improved visualization of lumbar spinal nerves, whereas overall image quality was comparable to 3 T MR neurography. This supports the feasibility of 7 T MR neurography of the lumbosacral plexus, even though image artifacts at 7 T were significantly increased.
