MRI of Peripheral Nerve: MT of Short T2 Components, Susceptibility and Diffusion Weighting of Collagen Components
Sameer Shah1, Qun He1, Micheal Carl2, Justin Brown1, Mark Mahan3, Graeme M. Bydder1, and Nikolaus M. Szeverenyi1

1University of California, San Diego, San Diego, CA, United States, 2Global MR Applications & Workflow, General Electric, San Diego, CA, United States, 3Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, United States

Synopsis

The objective of this paper is to describe the use of several new approaches for magnetic resonance (MR) imaging of peripheral nerves. MR examinations were performed on fresh human median, tibial and sciatic nerve samples, as well as cadaveric forearms at 3T and/or 11.7T as well as one fresh human median nerve sample. Application of MR techniques used elsewhere in the body, and the use of MR microscopy show a variety of new imaging findings in peripheral nerve. This approach is likely to improve understanding of the MR appearances of peripheral nerve and lead to improved experimental and clinical studies.

Introduction

This paper describes results from several new approaches for MR imaging of peripheral nerves. These include magnetization transfer of short T2 components, susceptibility and diffusion anisotropy in the collagen components of nerve as well as differential contrast enhancement with GdDTPA.

Methods

MR examinations were performed on fresh human median, tibial and sciatic nerve samples and cadaveric forearms at 3T and/or 11.7 T. Pre and post Gd images were obtained on human volunteers in a 3T clinical system. Ultrashort and zero echo time (UTE, ZTE), off-resonance saturation contrast (OSC), susceptibility weighted imaging, magic angle dipolar anisotropy imaging, and diffusion weighted imaging was performed on samples with the 3T and/or the 11.7T system.

Results

Use of UTE pulse sequences produced high signal from short and long T2 tissue components in nerve. The epineurium, perineurium and endoneurium/neuronal fiber compartments were easily recognized. Off-resonance saturation including magnetization transfer produced high short T2 tissue contrast (Fig 1). Magic angle effects in different nerve tissue components were demonstrated (Fig. 2). Obvious susceptibility differences between the perineurium and surrounding tissues were evident (Fig. 3). Diffusion contrast attributable to anisotropic restriction in collagen was seen in the perineurium. In Fig. 4 the perineurium is uniformly highlighted in (A), whereas in (B) only the vertical medial and lateral components perpendicular to the sensitization gradient are highlighted (arrow). In (C) the superior and inferior components of the perineurium are highlighted (arrow). These are the regions perpendicular to the Gy sensitization gradient. In (D) the perineurium is isointense with the endoneurium/neuronal fiber component. Diffusion contrast was also apparent in both the epineurium and endoneurium/neuronal fiber complex. Tractography showed directional differences within different tissue components of nerves. Contrast enhancement was separately seen in the epi-, peri and endoneurial/fiber complex of the median nerve in vivo . Over time the epi- and perineurium signal differences converged (Fig. 5). The rat sciatic nerve showed similar features to human nerve. Fixation produced a reduction in T1 and T2 in each of the neural components.

Discussion

Application of MR techniques used elsewhere in the body, and the use of MR microscopy show a variety of new imaging findings in peripheral nerve that have not been described previously1-3. These approaches are likely to improve understanding of the MR appearances of peripheral nerve and lead to improved experimental and clinical studies

Acknowledgements

No acknowledgement found.

References

1. Bilgen M, Heddings A, Al-Hafez B, Hasan W, Mclff T, Toby B, et al: Microneurography of human nerve. J Magn Reson 21: 826-830, 2005.

2. Naraghi AM, Awdeh H, Wadhwa V, Andreisek G, Chhabra A: Diffusion tensor imaging of peripheral nerves. Semin Musculoskelet Radiol 19: 191-200, 2015.

3. Chhabra A, Flammang A, Padua A Jr, Carrino JA, Andreisek G: Magnetic resonance neurography: technical considerations. Neuroimaging Clin N Am 24: 67-78, 2014

Figures

Fig. 1. Off-resonance saturation contrast sciatic nerve transverse 3D cones UTE (TE= 0.03ms) obtained by subtraction of the image with the off-resonance pulse from the image without the pulse (frequency offset 1000Hz, duration 12ms, flip angle= 1400°, 3 T). Short T2 tissues are highlighted.

Fig. 2. Magic angle effects in the median nerve. Images are from a 3D spin echo (TR=1000 TE=8ms) sequence at 11.7 T. Orientation of the specimen’s longitudinal axis to the static magnetic field direction was varied between 0°, 55° and 90°. Large intensity changes are observed in the epineurium.

Fig. 3. Phase changes arising from susceptibility effects in a spoiled GE sequence for a median nerve at 11.7T. Both the magnitude reconstruction image (A) and phase map (B) were obtained. The grayscale displays the phase (degrees of x,y-magnetization rotation) accumulation during the 3.5 ms TE (B).

Fig. 4. Anisotropy was observed in diffusion weighted images median nerve at 11.7 T. The panels show reference image, Gx, Gy, and Gz sensitized images (note directional arrows). The perineurium shows high signal when the sensitization is perpendicular to its surface (arrows).

Fig. 5. Signal intensity plots showing in various nerve tissues following contrast administration as shown in Figure 13. The time course of enhancement is well seen. Greater enhancement is seen in the epi- and perineurium compared with endoneurium/neuronal complex



Proc. Intl. Soc. Mag. Reson. Med. 24 (2016)
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