Combine contrast-enhanced 3D T2-weighted short inversion time inversion recovery MR neurography with MR angiography at 1.5 T in the assessment of brachial plexopathy.

Abstract

PURPOSE:

To explore the benefits of using a single injection of contrast agent at a 1.5 T system to perform both contrast-enhanced MR angiography (MRA) and 3D-T2-STIR MR neurography (MRN) to assess of brachial plexopathy.

METHODS:

In this prospective study, 27 patients with suspected brachial plexopathy, received an imaging procedure composed sequentially of non-enhanced 3D-T2-STIR, CE-MRA, and contrast-enhanced 3D-T2-STIR, using a 1.5 T MR scanner. Signal intensities and contrast ratios were compared with and without contrast agent. The non-enhanced and contrast-enhanced 3D-T2-STIR images were mixed for two experienced radiologists to rate image diagnostic quality in a blind manner. 3D images of MRN and MRA were merged to reveal the spatial relation between brachial plexopathy and concomitant vascular disorders.

RESULTS:

By comparing the non-enhanced with contrast-enhanced 3D-T2-STIR images, it revealed that the use of the contrast agent in 3D-T2-STIR MRN could significantly suppress the background signals contributed by small vein (P < 0.001), lymph node (P < 0.001), muscle (P < 0.001) and bone (P < 0.001). This improved the contrast ratios between the brachial plexus and its surrounding tissues (P < 0.001) and boosted the image's quality score (P < 0.01). Examining both CE-MRA and 3D-T2-STIR images revealed a relatively high incidence of concurrent vascular dysfunction in brachial plexopathy, with 39% of confirmed cases accompanied with subclavian and axillary vessel abnormalities.

CONCLUSION:

Combining contrast-enhanced 3D-T2-STIR MRN with MRA at a 1.5 T system significantly suppresses background signals, improves brachial-plexus display, and provides a direct assessment for both brachial plexus lesion and surrounding vascular injury.

• Authors: Zhengdao Xu, Tonghua Zhang, Jianxin Chen, Zongbao Liu, Tao Wang, Yijiang Hu, Jiahui Zhang, Feifei Xue
• Journal: Magma (New York, N.Y.) (MAGMA) Vol. 34 Issue 2 Pg. 229-239 (Apr 2021) ISSN: 1352-8661 [Electronic] Germany
• PMID: 32661842 (Publication Type: Journal Article)

Topics

• Angiography
• Brachial Plexus
• Brachial Plexus Neuropathies
• Humans
• Magnetic Resonance Imaging
• Prospective Studies