The application of paramagnetic contrast-based T2 effect to 3D heavily T2W high-resolution MR imaging of the brachial plexus and its branches

•Our MRN technique utilized paramagnetic contrast T2 effect/3D SPACE-STIR sequence.•This technique improved contrast between brachial plexus and surrounding tissues.•3D visualization of the brachial plexus can aid assessment of brachial plexopathy.

ObjectiveTo introduce a new 3D magnetic resonance neurography (MRN) method involving a paramagnetic contrast-based T2 effect coupled with an advanced 3D heavily T2W SPACE-STIR high resolution imaging sequence that would enhance the contrast between nervous tissue and surrounding tissues.MethodsThirty subjects (average age, 39.6 ± 17.0 years; 18 male and 12 female) were enrolled, including three patients with brachial plexopathy and 27 healthy volunteers. Subjective scores from two neuroradiologists, evaluating noncontrast MRN (cMRN) and 3D SPACE-STIR contrast enhanced MRN (ceMRN) 3D data using a 3-point scoring system, were compared using Wilcoxon signed-rank test. Contrast-to-noise ratios (CNRs), SNRs, and contrast ratios within the brachial plexus on cMRN vs. ceMRN MIP and source images were also compared using the paired t-test.ResultsThe average score for cMRN (0.77 ± 0.43) was significantly lower than ceMRN (1.73 ± 0.45) (p < 0.001). Lower nerve vs. vein CNRs were found on cMRN vs. ceMRN, respectively (p < 0.001 for both source and MIP images). All nerve-to-surrounding tissue contrast ratios (i.e., fat, muscle, veins, and bone) were higher for ceMRN compared with cMRN for both source and MIP images (all p < 0.05).ConclusionThe improved 3D visualization of the brachial plexus and its branches, using this new contrast-enhanced MRN method, can provide high resolution imaging which may be of significant value in the assessment of brachial plexopathy.