Purpose: To introduce, optimize, and assess the feasibility of a new scheme to rapidly acquire high-resolution volumetric neurographic images using a three-dimensional turbo spin-echo sequence combined with a diffusion-weighted pre-pulse called improved motion-sensitized driven equilibrium (iMSDE): Diffusion-prepared MR Neurography (D-prep MRN).
Methods: In order to optimize the signal suppression of blood vessels and muscle at D-prep MRN, coronal lumbosacral plexus images were acquired in five volunteers at 3T, and the following parameters were examined: iMSDE gradient-strength (b-value) of 0, 2 and 10 s/mm² (with the aim to suppress blood vessels) and iMSDE preparation duration (iMSDE_prep-time) of 18, 50 and 100 ms (with the aim to suppress muscle signal). Subsequently, the feasibility of the optimized D-prep MRN sequence in visualizing the brachial plexus, lumbosacral plexus, and cranial nerves was evaluated in 5 healthy volunteers.
Results: A higher b-value of 10 s/mm² was better in signal suppression of blood vessels, whereas an intermediate iMSDE_prep-time of 50 ms provided the best compromise between suppression of muscle signal and minimization of signal loss of nerves. With these parameters, the normal nerve structures showed high signal intensity, while the blood vessels and muscles were effectively suppressed. The optimized D-prep MRN sequence clearly showed the three-dimensional trajectory of the brachial plexus, lumbosacral plexus, and cranial nerves.
Conclusion: D-prep MRN was introduced and optimized, and clearly showed detailed anatomy of the brachial plexus, lumbosacral plexus, and cranial nerves. These results suggest that the D-prep MRN can be used for fast, high-resolution, volumetric imaging of the peripheral nervous system.