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

G Cheraya1, A S Tejani2, M Prakash3

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Magnetic Resonance Neurography (MRN) offers high-resolution peripheral nerve imaging, overcoming limitations of other methods. This review covers MRN technical foundations and introduces the NS-RADS system for standardized reporting.

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Area of Science:

  • Radiology
  • Neurology
  • Medical Imaging

Background:

  • Peripheral neuropathies have diverse causes and overlapping symptoms, complicating diagnosis.
  • Electrodiagnostic studies lack localization and characterization capabilities; ultrasonography has limitations for deep nerves.
  • Conventional MRI and electrodiagnostic testing have limitations in assessing peripheral nerve pathology.

Purpose of the Study:

  • To review the technical basis of Magnetic Resonance Neurography (MRN) for peripheral nerve imaging.
  • To outline essential hardware and sequence parameters for high-quality MRN.
  • To introduce the Nerve Imaging Reporting and Data System (NS-RADS) for standardized reporting.

Main Methods:

  • A narrative review synthesizing literature on peripheral neuropathies and MRN techniques.
  • Examination of technical parameters, sequence design, fat/vascular suppression, and 3D acquisitions for MRN optimization.
  • Review of relevant classification and reporting frameworks, including NS-RADS.

Main Results:

  • MRN provides high-resolution visualization of peripheral nerves, fascicular architecture, and denervation patterns.
  • Advanced MRN techniques, including specialized sequences and suppression strategies, enhance nerve visualization.
  • The NS-RADS system aims to improve reporting consistency and diagnostic confidence in MRN.

Conclusions:

  • MRN overcomes limitations of electrodiagnostic studies and conventional imaging by offering detailed structural and fascicular nerve assessment.
  • Understanding MRN's technical principles and standardized reporting is crucial for accurate interpretation and clinical use.
  • This review provides foundational knowledge for the clinical application of MRN in diagnosing peripheral neuropathies.