3D Brachial Plexus Neurography With Variable-Rate Selective Excitation RF Pulses

Area of Science:

• Radiology and Imaging Science
• Neuroimaging Techniques
• Medical Physics

Background:

• Conventional 3D turbo spin echo (TSE) for brachial plexus MRN uses long slab-selective RF pulses.
• These pulses can violate Carr-Purcell-Meiboom-Gill conditions, potentially increasing imaging artifacts.

Purpose of the Study:

• To evaluate if VERSE (Variable Echo Refocusing and Spatial Encoding) STIR-TSE improves nerve conspicuity and subjective appeal in brachial plexus MRN.
• To compare motion artifact levels between VERSE STIR-TSE and conventional STIR-TSE.

Main Methods:

• Prospective, cross-sectional study involving 24 subjects with suspected brachial plexopathy.
• 3-Tesla MRI scans using 3D STIR-TSE with and without VERSE pulse sequences.
• Qualitative assessment of nerve conspicuity and motion by three blinded radiologists; statistical analysis using Wilcoxon signed-rank tests.

Main Results:

• VERSE STIR-TSE was significantly preferred by all radiologists.
• No significant difference in motion artifact between VERSE and conventional STIR-TSE (p=0.11).
• Significantly greater conspicuity of the suprascapular nerve with VERSE; phantom studies showed increased signal in muscle and nerve mimics.

Conclusions:

• VERSE STIR-TSE offers superior image quality for brachial plexus MRN compared to conventional STIR-TSE.
• The technique improves nerve visualization without compromising motion artifact levels.
• VERSE STIR-TSE is a valuable advancement for brachial plexus neuroimaging.