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

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.