The application of enhanced three dimensional T₂WI turbo-spin-echo sequence with short-term inversion recovery and sampling perfection using different flip angle evolutions for high-resolution brachial plexus imaging

Objective: To investigate the clinical feasibility of contrast-enhanced three dimensional T₂WI turbo-spin-echo sequence with short-term inversion recovery and sampling perfection using different flip angle evolutions (3D STIR T₂WI SPACE) sequence in the brachial plexus neurography. Methods Thirty two patients were prospectively chosen and performed with brachial plexus plain scanning on a 3.0 T MR scanner by using plain and contrast-enhanced 3D STIR T₂WI SPACE sequence. Thirteen of them underwent plain scan, 9 of them underwent contrast-enhanced scan, and 10 of them underwent both plain scan and enhanced scan. The visibility of the brachial plexus were scored and contrast to noise ratio (CNR) were measured by two experienced radiologists. The results between plain and contrast-enhanced imaging were compared by t test. The 10 subjects received both enhance and plain imaging, were performed with paired t test. Results: In 32 patients, the visibility score of brachial plexus nerve and CNR were 7.8 ± 1.3 and 24.97 ± 3.41 in the plain scan group, and 13.1 ± 1.7 and 38.49 ± 4.95 in enhanced scan group, respectively. There were statistically significant differences in the two groups(t = -11.72, P < 0.01; t = -10.47, P < 0.01). In 10 cases with plain and enhanced brachial plexus imaging, the average score of the brachial plexus were 7.4 ± 1.7 and 13.3 ± 1.6, the average CNR were 26.23 ± 4.43 and 38.19 ± 5.03 respectively. There were statistically significant differences (t = -8.22, P < 0.01; t = -5.64, P < 0.01). The score results were analyzed for consistency. Plain images Kappa value was 0.684, which shows moderate consistency and enhanced images Kappa value = 0.822, which shows excellent consistency. Conclusions: The contrast-enhanced 3D STIR T₂WI SPACE sequences may suppress background tissue signals, which is helpful to display brachial plexus, therefore it is of important value for the early diagnosis of brachial plexus neuropathy. (authors)