Abstract
Objectives
Technical assessment of SHINKEI pulse sequence and conventional 3DIRTSE for LS plexus MR neurography.
Methods
Twenty-one MR neurography examinations of the LS plexus were performed at 3 T, using 1.5-mm isotropic 3DIRTSE and SHINKEI sequences. Images were evaluated for motion and pulsation artefacts, nerve signal-to-noise ratio, contrast-to-noise ratio, nerve-to-fat ratio, muscle-to-fat ratio, fat suppression homogeneity and depiction of LS plexus branches. Paired Student t test was used to assess differences in nerve conspicuity (p < 0.05 was considered statistically significant). ICC correlation was obtained for intraobserver performance.
Results
Four examinations were excluded due to prior spine surgery. Bowel motion artefacts, pulsation artefacts, heterogeneous fat saturation and patient motion were seen in 16/17, 0/17, 17/17, 2/17 on 3DIRTSE and 0/17, 0/17, 0/17, 1/17 on SHINKEI. SHINKEI performed better (p < 0.01) for nerve signal-to-noise, contrast-to-noise, nerve-to-fat and muscle-to-fat ratios. 3DIRTSE and SHINKEI showed all LS plexus nerve roots, sciatic and femoral nerves. Smaller branches including obturator, lateral femoral cutaneous and iliohypogastric nerves were seen in 10/17, 5/17, 1/17 on 3DIRTSE and 17/17, 16/17, 7/17 on SHINKEI. Intraobserver reliability was excellent.
Conclusion
SHINKEI MRN demonstrates homogeneous and superior fat suppression with increased nerve signal- and contrast-to-noise ratios resulting in better conspicuity of smaller LS plexus branches.
Key Points
• SHINKEI provides homogeneous and superior fat suppression, shown by higher nerve and muscle-to-fat ratios.
• SHINKEI shows better nerve signal-to-noise and contrast-to-noise ratios than 3DIRTSE.
• SHINKEI enables nerve-selective images with increased conspicuity of smaller LS plexus branches.
• SHINKEI should be considered in routine MR neurography of the LS plexus.
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Abbreviations
- 3DIRTSE:
-
three-dimensional inversion recovery turbo spin echo
- DWI:
-
diffusion-weighted imaging
- iMSDE:
-
improved Motion Sensitized Driven Equilibrium
- SHINKEI:
-
nerve-SHeath signal increased with INKed rest-tissue RARE Imaging
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Acknowledgements
Thanks to Yoneyama M, Masaya Takahashi, Dwayne Isbell and Ivan Dimitrov for the MRI sequence support. The scientific guarantor of this publication is Avneesh Chhabra. The authors of this manuscript declare relationships with the following companies: Dr. Chhabra has received research grants from GE-AUR (GERRAF), Siemens Medical Solutions and Integra Life Sciences. He also serves as a research consultant with Siemens CAD group. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.
Dr Chhabra has received research grants from GE-AUR (GERRAF), Siemens Medical Solutions, and Integra Life Sciences. He also serves as a research consultant with Siemens CAD group.
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3DIRTSE of LS plexus (MPG 1530 kb)
3D SHINKEI MPR of LS plexus (MPG 1814 kb)
3D SHINKEI MIP of LS plexus (MPG 1764 kb)
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Kasper, J.M., Wadhwa, V., Scott, K.M. et al. SHINKEI—a novel 3D isotropic MR neurography technique: technical advantages over 3DIRTSE-based imaging. Eur Radiol 25, 1672–1677 (2015). https://doi.org/10.1007/s00330-014-3552-8
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DOI: https://doi.org/10.1007/s00330-014-3552-8