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Improved Motion-Sensitized Driven Equilibrium-Prepared Inversion Recovery TSE Sequence for Ulnar Nerve MR Neurography
Guanghui Hong1, Junhuan Hong1, Dongmei Jiang1
1From the Department of Radiology (J.H., D.J., X.L., Y.P., P.H., M.T., D.S.), Neurosurgery (G.H.), Key Laboratory of Radiation Biology of Fujian higher education institutions (D.S.), the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China; Department of Radiology (J.H., D.J., X.L., Y.P., P.H., M.T., D.S.), Neurosurgery (G.H.), National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China and The School of Medical Imaging (J.H.), Fujian Medical University, Fuzhou, Fujian 350122, China.
Improved motion-sensitized driven equilibrium (iMSDE) inversion recovery TSE offers superior visualization for ulnar neuropathy. This non-contrast MRI technique provides excellent nerve and vein suppression, matching contrast-enhanced methods.
Area of Science:
- Radiology
- Neurology
- Medical Imaging
Background:
- Conventional inversion recovery TSE for ulnar neuropathy has limitations in venous and muscle suppression, often necessitating contrast agents.
- Improved motion-sensitized driven equilibrium (iMSDE) uses T2 magnetization preparation and diffuse gradients for enhanced signal suppression.
- This study evaluates iMSDE's efficacy in improving visualization for ulnar neuropathy detection.
Purpose of the Study:
- To assess the capability of inversion recovery TSE with iMSDE for visualizing ulnar neuropathy.
- To compare iMSDE inversion recovery TSE with conventional non-contrast and contrast-enhanced MRI sequences.
- To evaluate the diagnostic performance and image quality of iMSDE in ulnar neuropathy.
Main Methods:
- Twenty-nine patients with suspected ulnar neuropathy underwent 3T MRI, including non-contrast, contrast-enhanced, and iMSDE inversion recovery TSE sequences.
- Image quality, nerve visualization, suppression of surrounding tissues, and diagnostic confidence were assessed using a Likert scale.
- Quantitative analysis included signal-to-noise ratio (SNR) and contrast ratio, alongside nerve cross-sectional area measurements compared to ultrasound and electrophysiology.
Main Results:
- iMSDE inversion recovery TSE achieved the highest subjective muscle suppression and nerve-to-muscle contrast ratio.
- Compared to non-contrast MRI, iMSDE demonstrated superior nerve visualization, venous suppression, diagnostic confidence, and nerve-to-vein SNR (p < 0.001).
- iMSDE showed comparable nerve visualization, venous suppression, and diagnostic confidence to contrast-enhanced MRI (p > 0.05), with excellent agreement in cross-sectional area measurements with ultrasound.
Conclusions:
- iMSDE inversion recovery TSE effectively visualizes ulnar nerve morphology and pathology.
- This technique offers a feasible, non-contrast alternative for detecting ulnar neuropathy.
- The findings support iMSDE as a valuable tool in the diagnosis of ulnar nerve conditions.
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