Learning objectives
The purpose of this abstract is to provide a practical approach to Radiographers and radiology residents in order to understand the MR Neurography (MRN) of the brachial plexus.
In more detail,
imaging specifications,
artifacts and pitfalls,
and the clinical utility of the brachial plexus MRN are discussed.
Background
The brachial plexus is a complex network of nerves formed by the anterior rami of the lower four cervical nerves (C5,
C6,
C7,
C8) and first thoracic nerve (T1),
which supplies motor and sensory innervation to the upper limb and pectoral girdle.
Diagnosing brachial plexus pathology was mainly based on medical history,
clinical findings and electromyography (EMG) testing,
while Computed Tomography (CT) and traditional Magnetic Resonance Imaging (MRI) was used to assess tumours.
However,
diagnosing brachial plexus pathology can be really challenging,
often necessitating further...
Findings and procedure details
Imaging Specifications
Field strength
MR Neurography should be performed either at 3T or 1.5T MRI systems.
3T systems are preferred because they provide greater signal-to-noise ratio (SNR),
which can result in higher resolution images and/or faster acquisition times.
1.5T systems should be used when scanning patients with metallic implants to reduce susceptibility artifacts.
Imaging plane
Traditional protocols include all three imaging planes (axial,
coronal,
sagittal).
Coronal is the most important plane because it can depict all nerves together and demonstrates their longitudinal extent.
Sagittal planeshould...
Conclusion
MR Neurography is a great modality for the high quality,
high resolution imaging of the brachial plexus.
Anatomical and functional sequences can be used for the detailed assessment of the brachial plexus and related pathology.
They offer great anatomical information and provide an accurate in vivo evaluation of the locus and extent of the lesion.
MRN is a valuable adjunct to clinical examination,
EMG and traditional MRI,
however,
Radiographers should be awareof the new techniques,
imaging parameters and slice positioning in order to highlight the...
Personal information
Christos Tsiotsios B.Sc.,
LeadMRI Radiographer,
German Oncology Center,
Limassol,
Cyprus;
[email protected]
Sopiko Kutsniashvili B.Sc.,
Radiotherapy Technologist,
German Oncology Center,
Limassol,
Cyprus;
[email protected]
Michael EleftheriouB.Sc.,
Cross-Sectional Radiographer,German Oncology Center,
Limassol,
Cyprus;
[email protected]
Bac Nguyen B.Sc.,
Lead MRI Radiographer,
Oslo University Hospital,
Oslo,
Norway;
[email protected]
References
Mürtz P,
Kaschner M,
Lakghomi A,
Gieseke J,
Willinek WA,
Schild HH,
Thomas D.
Diffusion-weighted MR neurography of the brachial and lumbosacralplexus: 3.0 T versus 1.5 T imaging.
Eur J Radiol.
2015; 84(4): 696-702.
Rehman I,
Chokshi FH,
Khosa F.
MR imaging of the brachial plexus.
Clin Neuroradiol.
2014; 24(3):207-16.
Wang L,
Niu Y,
Kong X,
Yu Q,
Kong X,
Lv Y,
Shi H,
Li C,
Wu W,
Wang B,
Liu D.The application of paramagnetic contrast-based T2 effect to 3D heavily T2W high-resolution MR imaging...