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.

中文翻译：

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将对比增强 3D T2 加权短反转时间反转恢复 MR 神经成像与 1.5 T MR 血管造影相结合，评估臂丛病。

目的

探讨在 1.5 T 系统中使用单次注射造影剂进行对比增强 MR 血管造影 (MRA) 和 3D-T2-STIR MR 神经成像 (MRN) 以评估臂丛病的益处。

方法

在这项前瞻性研究中，27 名疑似臂丛神经病变的患者使用 1.5 T MR 扫描仪接受了依次由非增强 3D-T2-STIR、CE-MRA 和对比增强 3D-T2-STIR 组成的成像程序。比较使用和不使用造影剂时的信号强度和对比度。两位经验丰富的放射科医生将非增强和对比度增强的 3D-T2-STIR 图像混合在一起，以盲目的方式评估图像诊断质量。合并 MRN 和 MRA 的 3D 图像以揭示臂丛神经病变与伴随血管疾病之间的空间关系。

结果

通过对比未增强和对比增强的 3D-T2-STIR 图像，发现在 3D-T2-STIR MRN 中使用造影剂可以显着抑制由小静脉（P  < 0.001）、淋巴节点 ( P  < 0.001)、肌肉 ( P  < 0.001) 和骨骼 ( P  < 0.001)。这提高了臂丛神经与其周围组织之间的对比度（P  < 0.001）并提高了图像的质量得分（P  < 0.01）。检查 CE-MRA 和 3D-T2-STIR 图像显示臂丛病并发血管功能障碍的发生率相对较高，39% 的确诊病例伴有锁骨下和腋窝血管异常。

结论

在 1.5 T 系统下将对比增强的 3D-T2-STIR MRN 与 MRA 相结合，可显着抑制背景信号，改善臂丛神经显示，并为臂丛神经病变和周围血管损伤提供直接评估。