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KMID : 0858520160200020081
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Journal of the Korean Society of Magnetic Resonance in Medicine
2016 Volume.20 No. 2 p.81 ~ p.87
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Detecting Peripheral Nerves in the Elbow using Three-Dimensional Diffusion-Weighted PSIF Sequences: a Feasibility Pilot Study
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Na Do-Min
Ryu Jae-Il
Hong Suk-Joo
Hong Sun-Hwa
Yoon Min-A
Ahn Kyung-Sik
Kang Chang-Ho
Kim Baek-Hyun
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Abstract
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Purpose: To analyze the feasibility of three-dimensional (3D) diffusion-weighted (DW) PSIF (reversed FISP [fast imaging with steady-state free precession]) sequence in order to evaluate peripheral nerves in the elbow.
Materials and Methods: Ten normal, asymptomatic volunteers were enrolled (6 men, 4 women, mean age 27.9 years). The following sequences of magnetic resonance images (MRI) of the elbow were obtained using a 3.0-T machine: 3D DW PSIF, 3D T2 SPACE (sampling perfection with application optimized contrasts using different flip angle evolution) with SPAIR (spectral adiabatic inversion recovery) and 2D T2 TSE (turbo spin echo) with modified Dixon (m-Dixon) sequence. Two observers used a 5-point grading system to analyze the image quality of the ulnar, median, and radial nerves. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of each nerve were measured. We compared 3D DW PSIF images with other sequences using the Wilcoxon-signed rank test and Friedman test. Inter-observer agreement was measured using intraclass correlation coefficient (ICC) analysis.
Results: The mean 5-point scores of radial, median, and ulnar nerves in 3D DW PSIF (3.9/4.2/4.5, respectively) were higher than those in 3D T2 SPACE SPAIR (1.9/2.8/2.8) and 2D T2 TSE m-Dixon (1.7/2.8/2.9) sequences (P < 0.05). The mean SNR in 3D DW PSIF was lower than 3D T2 SPACE SPAIR, but there was no difference between 3D DW PSIF and 2D T2 TSE m-Dixon in all of the three nerves. The mean CNR in 3D DW PSIF was lower than 3D T2 SPACE SPAIR and 2D T2 TSE m-Dixon in the median and ulnar nerves, but no difference among the three sequences in the radial nerve.
Conclusions: The three-dimensional DW PSIF sequence may be feasible to evaluate the peripheral nerves around the elbow in MR imaging. However, further optimization of the image quality (SNR, CNR) is required.
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KEYWORD
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3T MR neurography, 3D DW PSIF, Elbow joint, Peripheral nerve
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