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Erschienen in:
07.05.2021 | Scientific Article
Ferumoxytol-enhanced vascular suppression in magnetic resonance neurography
Erschienen in: Skeletal Radiology | Ausgabe 11/2021
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Objective
To evaluate ferumoxytol-enhanced vascular suppression for visualizing branch nerves of the brachial plexus in magnetic resonance (MR) neurography.
Materials and methods
Signal simulations were performed to determine ferumoxytol’s effect on nerve-, fat-, and blood-to-muscle contrast and to optimize pulse sequence parameters. Prospective, in vivo assessment included 10 subjects with chronic anemia who underwent a total of 19 (9 bilateral) pre- and post-infusion brachial plexus exams using three-dimensional (3D), T2-weighted short-tau inversion recovery (T2-STIR) sequences at 3.0 T. Two musculoskeletal radiologists qualitatively rated sequences for the degree of vascular suppression and brachial plexus branch nerve conspicuity. Nerve-to-muscle, -fat, and -vessel contrast ratios were measured.
Results
Quantitative nerve/muscle and nerve/small vessel contrast ratios (CRs) increased with ferumoxytol (p < 0.05). Qualitative vascular suppression and suprascapular nerve visualization improved following ferumoxytol administration for both raters (p < .05). Pre- and post-ferumoxytol exams demonstrated moderate to near-perfect inter-rater agreement for nerve visualization and diagnostic confidence for the suprascapular and axillary nerves but poor to no agreement for the long thoracic nerve.
Conclusion
Ferumoxytol in T2-weighted brachial plexus MR neurography provides robust vascular suppression and aids visualization of the suprascapular nerve in volunteers without neuropathy.