Magnetic resonance neurography

Last revised by Frank Gaillard on 14 Feb 2022

Citation, DOI, disclosures and article data

Citation:

Idris M, Gaillard F, Glick Y, Magnetic resonance neurography. Reference article, Radiopaedia.org (Accessed on 16 Apr 2024) https://doi.org/10.53347/rID-56357

DOI:

https://doi.org/10.53347/rID-56357

Permalink:

https://radiopaedia.org/articles/56357

rID:

56357

Article created:

1 Nov 2017, Muhammad Idris ◉

Disclosures:

At the time the article was created Muhammad Idris had no recorded disclosures.

View Muhammad Idris's current disclosures

Last revised:

14 Feb 2022, Frank Gaillard ◉ ◈

Disclosures:

At the time the article was last revised Frank Gaillard had no recorded disclosures.

View Frank Gaillard's current disclosures

Revisions:

4 times, by 3 contributors - see full revision history and disclosures

Systems:

Musculoskeletal, Spine

Sections:

Approach, Imaging Technology

Tags:

stub cases

Synonyms:

Magnetic resonance neurography (MRN)
MRN
High-resolution high-contrast magnetic resonance neurography (HRHC-MRN)
HRHC-MRN

Magnetic resonance neurography (MRN) is a relatively new non-invasive imaging technique for dedicated assessment of peripheral nerves.

It is used to assess peripheral nerve entrapments and impingements as well as localization and grading of nerve injuries and lesions.

Dedicated high-resolution MR sequences, sometimes referred to as high-resolution high-contrast magnetic resonance neurography (HRHC-MRN) designed to facilitate the visualization of peripheral nerves. They are typically highly T2-weighted sequences allowing the high-signal nerves to stand out from the darker fat-suppressed background soft tissues.

Examples include ^1-10:

3D turbo spin echo with variable flip-angle (SPACE) short-tau inversion recovery (STIR) sequence with contrast to improve background suppression 1.
3D turbo spin-echo short-tau inversion recovery with pseudosteady-state with motion sensitized driven equilibrium (MSDE)
3D double-echo steady-state with water excitation (3D-DESS-WE)
3D reversed fast imaging with steady-state precession (3D PSIF)
3D constructive interference in steady-state (3D CISS)

These sequences are then typically viewed in oblique planes to maximize visualitision of specific nerves at specific locations (both longitudinally and in cross-section) as well as variablly thick MIP slabs to give a greater overview of the nerves ^5,6.

Use of intravenous gadolinium contrast is usually restricted for assessment of infection, perineural involvement by tumor or to further assess mass lesions, however, in some settings intravenous contrast can be added to aid in background signal suppression due to their T2* effects ⁵.

References

1. Chhabra A1, Andreisek G, Soldatos T, Wang KC, Flammang AJ, Belzberg AJ, Carrino JA. MR neurography: past, present, and future. AJR Am J Roentgenol. 2011 Sep;197(3):583-91. doi: 10.2214/AJR.10.6012.
2. Du R1, Auguste KI, Chin CT, Engstrom JW, Weinstein PR. Magnetic resonance neurography for the evaluation of peripheral nerve, brachial plexus, and nerve root disorders. J Neurosurg. 2010 Feb;112(2):362-71. doi: 10.3171/2009.7.JNS09414.
3. Chhabra A, Williams EH, Wang KC, Dellon AL, Carrino JA. MR neurography of neuromas related to nerve injury and entrapment with surgical correlation. AJNR 2010; 31:1363–1368
4. Chhabra A, Bajaj G, Wadhwa V, Quadri RS, White J, Myers LL, Amirlak B, Zuniga JR. MR Neurographic Evaluation of Facial and Neck Pain: Normal and Abnormal Craniospinal Nerves below the Skull Base. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (5): 1498-1513. doi:10.1148/rg.2018170194 - Pubmed
5. Wu W, Wu F, Liu D et al. Visualization of the Morphology and Pathology of the Peripheral Branches of the Cranial Nerves Using Three-Dimensional High-Resolution High-Contrast Magnetic Resonance Neurography. Eur J Radiol. 2020;132:109137. doi:10.1016/j.ejrad.2020.109137 - Pubmed
6. Li S, Zhang S, Yu Z, Lin Y. MRI of the Intraorbital Ocular Motor Nerves on Three-Dimensional Double-Echo Steady State with Water Excitation Sequence at 3.0 T. Jpn J Radiol. 2021;39(8):749-54. doi:10.1007/s11604-021-01111-x - Pubmed
7. Fujii H, Fujita A, Yang A et al. Visualization of the Peripheral Branches of the Mandibular Division of the Trigeminal Nerve on 3D Double-Echo Steady-State with Water Excitation Sequence. AJNR Am J Neuroradiol. 2015;36(7):1333-7. doi:10.3174/ajnr.a4288 - Pubmed
8. Fujii H, Fujita A, Kanazawa H, Sung E, Sakai O, Sugimoto H. Localization of Parotid Gland Tumors in Relation to the Intraparotid Facial Nerve on 3D Double-Echo Steady-State with Water Excitation Sequence. AJNR Am J Neuroradiol. 2019;40(6):1037-42. doi:10.3174/ajnr.a6078 - Pubmed
9. Fujii H, Fujita A, Yang A et al. Visualization of the Peripheral Branches of the Mandibular Division of the Trigeminal Nerve on 3D Double-Echo Steady-State with Water Excitation Sequence. AJNR Am J Neuroradiol. 2015;36(7):1333-7. doi:10.3174/ajnr.a4288 - Pubmed
10. Van der Cruyssen F, Croonenborghs T, Hermans R, Jacobs R, Casselman J. 3D Cranial Nerve Imaging, a Novel MR Neurography Technique Using Black-Blood STIR TSE with a Pseudo Steady-State Sweep and Motion-Sensitized Driven Equilibrium Pulse for the Visualization of the Extraforaminal Cranial Nerve Branches. AJNR Am J Neuroradiol. 2020;42(3):578-80. doi:10.3174/ajnr.a6904 - Pubmed