The Study Of Magnetic Resonance Neurography In Brachial Plexus

PART1THE STUDY OF THE ARTIFACT IN THE IMAGINGOF BRACHIAL PLEXUS ON3D-FSE CUBE SEQUENCEObjective: To probed the artifact types and degree of the image ofbrachial plexus on the3D-FSE Cube sequence;Method: To observed the artifacts of image on T model waterphantom;Brachial plexus in30normal volunteers with3D-FSE Cubesequence, mages were postprocessed with MIP and CPR inADW4.4,observed and statisticed the shapes and types of theartifats,measured the band of its,caculate the proportion of different artifatsin the same time;Results:Multiple slightly low signal artifacts were seen on vertical partor junction of vertical and horizontal part;the occurrence rate of the artifatson brachial plexus imaging was83.33%in the group, the type of artifactsmainly broadband-like low signal,triangle-like low signal and linear low signal,their occurrence rate was40.0%,43.33%,83.33%,respectively,andthe occurrence rate of poor fat suppression was76.67%.Conclusion the phenomenon of low signal artifacts and poor fatsuppression were existed in the imaging of brachial plexus on3D-FSECube sequence,and its interfered the imaging quality seriously. PART2APPLICATION OF THE ASSISTIVE DEVICE FORSHIMMING OF MAGNETIC RESONANCE IMAGING INBRACHIAL PLEXUSObjective: To evaluate the application value of the assistive device madeby ourselves for shimming on3D-FSE Cube sequence magnetic resonanceimaging in normal brachial plexus.Methods: Brachial plexus in30normal volunteers underwent the sameMR scan for2times with3D-FSE Cube sequence, and the assistive devicewas used in the second time. The signal of nerve, muscle and backgroundnoise was measured. Images were postprocessed with MIP and CPR, andthen image quality was assessed.SNR and contrast-to-noise ratio (CNR)were calculated. Results: Low signal artifact on neck and nonuniform fat suppressionoccurred on conventional images, and the image quality grade of brachialplexus at various anatomic levels (roots, interscalene area, costoclavicularspace, and axillary level) were2.38±0.64,2.45±0.53,1.73±0.66,1.95±0.53.After using the assistive device, the artifact on neck disappeared, and theeffect of fat suppression was better than before. The image quality grade ofvarious anatomic levels in brachial plexus were3.95±0.21,3.82±0.39,3.38±0.55,1.97±0.41, higher than conventional images in the level of roots,interscalene area, costoclavicular space (all P＜0.001). SNR and CNR ofconventional images was13.14±4.37and6.65±2.96, respectively. Afterusing the assistive device, the SNR and CNR of images was15.10±5.91and8.03±3.63, higher than those of conventional images (both P＜0.05).Conclusion: The assistive device for shimming can improve the uniformityof local magnetic field and the image quality of brachial plexus on3D-FSECube sequence. PART3COMPARED WITH IDEAL AND3D-FSE CUBE IN NORMALPOSTGANGLIONIC BRACHIAL PLEXUSObjective:To compare the sequences of IDEAL and3D-FSE Cubeimaging of brachial plexus.Methods: Brachial plexus of30volunteers were imaged on3.0T MRsystem with sequences of3D-FSE Cube and IDEAL, and all of thevolunteers underwent the same MR scan for2times with3D-FSE Cubesequence, The assistive device was used in the second time. Images werepostprocessed with MIP and CPR, and then the display rate wascalculated,and image quality was assessed, Signal noise ratio (SNR) andcontrast-to-noise ratio (CNR) were calculated.Results: The display rate of ganglion and supra clavicular nerve onIDEAL and3D-FSE Cube were96.67%、100%,and86.67%、96.67%,respectively, There was no statistically significantdifference both of them (P>0.05),The infra clavicular nerve was shownbetter on3D-FSE Cube(93.33%)than IDEAL(70%),(P <0.05). In levels ofganglion, The imaging quality on IDEAL and3D-FSE Cube had nostatistically significant difference (P>0.05),In the levels of interscalenearea, costoclavicular space,axillary, The imaging quality of3D-FSE Cubewas better than IDEAL (P<0.05), In the level of ganglion, the singal ofIDEAL higher than3D-FSE Cube(P<0.05), And there was no statisticallysignificant difference on other level of brachial plexus(P>0.05),The SNRand CNR of IDEAL were both higher than3D-FSE Cube(P=0.000). Conclusion: The sequences of IDEAL and3D-FSE Cube both had thecapacity of clearly shown postganglionic brachial plexus,But the imagingquality of3D-FSE Cube was better than IDEAL. PART4THE STUDY OF CLINICAL APPLICATION OF BRACHIALPLEXUS ON3.0T MRObjective: To explore the clinical application of brachial plexus with thesequences of IDEAL and3D-FSE Cube on3.0T MR.methods:25patients were scaned with IDEAL sequence,14patientswere scaned with3D-FSE Cube sequence on3.0T MR,respectively,theassistive device was used on the3D-FSE Cube sequence.The images wereprocessed on AWD4.4workstation,the charateristics of brachialplexopathies were observed, and to contrast the results of MR and EMG.Results:In the25patients with IDEAL sequence,17patients weretraumatic injury,its included edema and increased signal of brachialplexus(15cases,88.2%),tuaumatic meningocele(11cases,65.7%),fractureof nerve root(4cases,23.5%), neuroinflammatory lesions (2cases),tumor lesions(6cases);In the14patients with3D-FSE Cube sequence,10patientswere traumatic injury,its inculded edema and increased signal of brachialplexus(9cases,90%),tuaumatic meningocele(3cases,37.5%), the continuityof nerve was breaked (1case,10%),neuroinflammatory lesions (2cases),tumor lesions(2cases);To contrast with EMG,thesensitivity,specificity,accuracy rate of IDEAL and3D-FSE Cube is87%,100%,88%and92.3%,100%,92.9%,respectively.conclusion:The IDEAL and3D-FSE Cube sequence(combined withassistive device) has important clinical application value in brachial plexusneuropathy on3.0T MR.