MRI protocol for Neurography

High-resolution peripheral nerve imaging requires careful consideration of coil selection, pulse sequence, method of fat suppression, section thickness, and field of view (6). Successful identification of subtle nerve abnormalities by use of MR neurography requires that the imaging parameters be optimized to maximize the signal-to-noise ratio, that spatial and contrast resolution sufficient to permit accurate delineation of fascicular morphology and nerve signal intensity be produced, and that a reasonable imaging time be maintained.Pelvic phase-array coils provide satisfactory coverage of the lumbosacral plexus but are inadequate for examining the sciatic nerve in most patients.

 We used to do in our 1.5 T avanto,4- to 7-mm section thickness, 0-mm intersection gap, 18- to 24-cm field of view, 256 × 192 to 256 matrix, and an 8- to 10-minute imaging time per sequence.

The sequences(high-resolution) mainly used in "MRI protocol for Neurography"

• Coronal T1 SE
• Coronal T2 FSE Fat Sat  or STIR 
• Axial T1 SE
• Axial T2 FSE Fat Sat  or STIR 
• Sagital T1 SE
• Sagital T2 FSE Fat Sat  or STIR 

Post Contrast "MRI protocol for Neurography"

• T1 Fat sat Spin Echo Coronal
• T1 Fat sat Spin Echo Axial
• T1 Fat sat Spin Echo Sagital(Optional)

Technical notes "MRI protocol for Neurography"

• Coronal/Axial  imaging coverage from L3 through the ischial tuberosity centered in the midline the sacral ala through the ischial tuberosity 
• Sagital imaging coverage from the sacral ala through the ischial tuberosity 
• T1-weighted imaging is used to define the bony structures and tissue planes surrounding the nerves
• T2-weighted or fast spin-echo inversion recovery images, the normal sciatic nerve is slightly hyperintense to adjacent muscle and hypointense to regional vessels, with clearly defined fascicles separated by interposed lower signal connective tissue
• The normal sciatic nerve  is a well-defined oval structure with discrete fascicles isointense to adjacent muscle tissue on T1-weighted images
• Suppress the normal high signal intensity of fat to make the nerves more conspicuous