Magnetic Resonance Neurography (MRN): part 1- basic concepts, technical considerations, interpretation, and clinical...

To review the technical foundations of Magnetic Resonance Neurography (MRN), outline key hardware and sequence considerations for high‑quality peripheral nerve imaging, and introduce the NS‑RADS reporting system as part of a two‑part series on MRN.

This narrative review synthesizes current literature on peripheral neuropathies and MRN, including studies evaluating electrodiagnostic testing, ultrasonography, conventional MRI, and advanced MRN techniques. Technical parameters, sequence design, fat and vascular suppression strategies, and 3D isotropic acquisitions were examined to provide a comprehensive overview of MRN optimization. Relevant classification and reporting frameworks, including NS‑RADS, were also reviewed.

Peripheral neuropathies arise from diverse traumatic, compressive, inflammatory, metabolic, and neoplastic etiologies, often presenting with overlapping clinical features that complicate diagnosis. Electrodiagnostic studies offer functional assessment but have limitations in localizing and characterizing lesions. Ultrasonography provides complementary structural information but is constrained by operator dependence and reduced sensitivity for deep nerves. MRN has emerged as a transformative modality, enabling high‑resolution visualization of peripheral nerves, fascicular architecture, and denervation patterns through advanced hardware, robust suppression techniques, and nerve‑selective sequences. This article summarizes the technical principles underlying MRN and introduces NS‑RADS to enhance reporting consistency and diagnostic confidence.

MRN addresses key limitations of conventional imaging and electrodiagnostic evaluation by providing detailed structural and fascicular assessment of peripheral nerves. Understanding its technical foundations and standardized reporting framework is essential for accurate interpretation and optimal clinical application. The companion article in this series focuses on clinical utility, characteristic imaging features, and hallmark MRN signs across common and uncommon neuropathies.