Magnetic resonance neurography

Last revised by Frank Gaillard on 14 Feb 2022

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

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