AJNR. American journal of neuroradiology · 2026
Comparison of 3D Multiecho in Steady-State Acquisition and Short-Tau Inversion Recovery Sequences in Brachial Plexus MR Neurography.
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Lowe Allison S, Sneag Darryl B, Lin Ji, Colucci Philip G, Wang Shu-Han, Wen Yan, Fung Maggie, Tan Ek T
Аннотация
BACKGROUND AND PURPOSE: The STIR-FSE pulse sequence is commonly used for 3D MR neurography (MRN) of the brachial plexus (BP) due to its low B0 susceptibility and robust fat suppression. An alternative 3D acquisition is a multiecho in steady-state acquisition (MENSA-NERVE) sequence that typically provides more robust vascular suppression but poorer fat suppression due to its use of a water excitation pulse.
MATERIALS AND METHODS: A total of 50 subjects (24 women, median age [range]: 34 years [14-73 years]) underwent unilateral BP MRN at 3T where noncontrast STIR-FSE and MENSA-NERVE were sequentially acquired and retrospectively analyzed. Sequences were assessed by 2 radiologists for vascular suppression, fat suppression, and visualization of the BP nerve roots, trunks, and cords, as well as of the suprascapular nerve and axillary nerve. Pooled measurements were analyzed using the Wilcoxon signed-rank test, and agreement proportion was used to assess interrater/intersequence diagnostic agreement.
RESULTS: MENSA-NERVE outperformed STIR-FSE for vascular suppression (P < .001). Fat suppression assessments favored STIR-FSE over MENSA-NERVE (P = .05 to P < .001), with incomplete fat suppression obscuring nerve visualization in MENSA-NERVE, primarily observed only at the lung apex. MENSA-NERVE provided superior visualization of the suprascapular and axillary nerves (P = .004 to P < .001). Interrater agreement of visualized pathology was good to excellent (agreement = 0.74-0.92) for both sequences. Intersequence agreement was also excellent (agreement = 0.80-0.88).
CONCLUSIONS: MENSA-NERVE provided superior vascular suppression and nerve conspicuity compared with noncontrast STIR-FSE and with less robust fat suppression at the neck-shoulder junction and lung apex.
MATERIALS AND METHODS: A total of 50 subjects (24 women, median age [range]: 34 years [14-73 years]) underwent unilateral BP MRN at 3T where noncontrast STIR-FSE and MENSA-NERVE were sequentially acquired and retrospectively analyzed. Sequences were assessed by 2 radiologists for vascular suppression, fat suppression, and visualization of the BP nerve roots, trunks, and cords, as well as of the suprascapular nerve and axillary nerve. Pooled measurements were analyzed using the Wilcoxon signed-rank test, and agreement proportion was used to assess interrater/intersequence diagnostic agreement.
RESULTS: MENSA-NERVE outperformed STIR-FSE for vascular suppression (P < .001). Fat suppression assessments favored STIR-FSE over MENSA-NERVE (P = .05 to P < .001), with incomplete fat suppression obscuring nerve visualization in MENSA-NERVE, primarily observed only at the lung apex. MENSA-NERVE provided superior visualization of the suprascapular and axillary nerves (P = .004 to P < .001). Interrater agreement of visualized pathology was good to excellent (agreement = 0.74-0.92) for both sequences. Intersequence agreement was also excellent (agreement = 0.80-0.88).
CONCLUSIONS: MENSA-NERVE provided superior vascular suppression and nerve conspicuity compared with noncontrast STIR-FSE and with less robust fat suppression at the neck-shoulder junction and lung apex.