Improved visualization of diffusion-prepared MR neurography (SHINKEI) in the lumbosacral plexus combining high-intensity reduction (HIRE) technique |
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| Institution: | 1. Department of Radiology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan;2. Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan;1. Department of Ophthalmology, University of California, San Francisco, San Francisco, California;2. Department of Family Medicine, East Pierce Family Medicine, Puyallup, Washington;3. Department of Ophthalmology, Palo Alto Medical Foundation, Palo Alto, California;1. Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany;2. Philips Healthcare, Lübeckertordamm 5, 20099 Hamburg, Germany;1. Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, 1-8-1 Inohana, Chuo-ku 260-0856, Japan;2. Department of Orthopaedic Surgery, Shimoshizu National Hospital, 934-5, Shikawatashi, Yotsukaido, Chiba 284-0003, Japan;3. Department of Orthopaedic Surgery, Eastern Chiba Medical Center, 3-6-2 Okayamadai, Togane, Chiba 283-8686, Japan;4. Department of Radiology, Eastern Chiba Medical Center, 3-6-2 Okayamadai, Togane, Chiba 283-8686, Japan;5. Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan;6. MR Clinical Science, Philips Japan, 2-13-37 Konan, Minato-ku, Tokyo 108-8507, Japan;7. Department of Orthopedic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-City, Ibaraki 305-8575, Japan;8. Department of Orthopaedic Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan;9. Department of Orthopaedic Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba 285-8741, Japan;1. Department of Orthopaedic Surgery, Shimoshizu National Hospital, 934-5, Shikawatashi, Yotsukaido, Chiba 284-0003, Japan;2. Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, 1-8-1 Inohana, Chuo-ku, 260-0856, Japan;3. Department of Orthopaedic Surgery, Eastern Chiba Medical Center, 3-6-2 Okayamadai, Togane, Chiba 283-8686, Japan;4. Department of Radiology, Eastern Chiba Medical Center, 3-6-2 Okayamadai, Togane, Chiba 283-8686, Japan;5. Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan;6. MR Clinical Science, Philips Japan, 2-13-37 Konan, Minato-ku, Tokyo 108-8507, Japan;7. Department of Orthopedic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-City, Ibaraki 305-8575, Japan;8. Department of Orthopaedic Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan;9. Department of Orthopaedic Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba 285-8741, Japan |
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| Abstract: | PurposeThis study attempted to improve visualization of the pelvic nervous system using the high-intensity reduction (HIRE)-nerve-SHeath signal increased with INKed rest-tissue RARE Imaging (SHINKEI) technique that involves subtracting signals of 3D heavily T2W images from SHINKEI images. We identified the optimum TE value for 3D heavily T2W images and assessed the usefulness of the HIRE-SHINKEI technique.Materials and methodsCoronal lumbosacral plexus images were acquired from six healthy volunteers at 3 T. We optimized the TE of the 3D heavily T2-weighted (T2W) images in HIRE-SHINKEI and compared HIRE-SHINKEI images with conventional SHINKEI images with respect to nerve depiction, and vein, bladder, and cerebrospinal fluid (CSF) signal suppression using a 5-point scale.ResultsIn 3D heavily T2W images optimized by HIRE-SHINKEI technique, the signal corresponding to nerves became significantly lower at TE = 400 ms (p < 0.0005), while that of veins occurred at TE = 400 ms and 600 ms (p < 0.05). The suppression of bladder signals was significant at TE = 400, 600, and 800 ms (p < 0.05); however, there was no difference in signal inhibition from CSF at all TEs tested. Based on these results, an optimal TE of 600 ms was identified for 3D heavily T2W images; these images corresponded to the minimal loss of nerve signal and simultaneous maximum subtraction of signals from the bladder, vein, and CSF with dissimilar T2 values. Compared with SHINKEI images, the optimized HIRE-SHINKEI images selectively delineated nerves in greater detail, and along with significant signal suppression of the bladder (p < 0.0001) and veins (p < 0.05).ConclusionHIRE-SHINKEI can be used to better visualize the lumbosacral plexus with higher signal suppression of other pelvic structures. Such detailed Magnetic resonance neurography and selective depiction of nerves are useful for the diagnosis of peripheral nerve disorders. |
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