title: Diffusion-prepared neurography of the brachial plexus with a large field-of-view at 3T.
abstract: OBJECTIVE
  To study diffusion-prepared neurography optimized for a large field-of-view (FOV) to include the neck and both shoulders. In a large FOV poor homogeneity of the magnetic field (B0 ) often leads to poor image quality and possibly to poor diagnostic accuracy. The aim was therefore to find an optimal (combination of) shimming method(s) for diffusion-prepared neurography in a large FOV.
  
  
  METHODS
  A 3D diffusion-prepared sequence with a large FOV was tested with and without the use of a susceptibility-matched pillow combined with image-based (IB) or standard shimming in six healthy volunteers on a 3T system. B0 , B1 , signal to noise ratio (SNR), and contrast to noise ratio (CNR) were compared between all protocols. Additionally, nerve visibility, fat suppression, artifacts, and overall image quality were ordinally (5-point scale) assessed by two readers. Furthermore, correlations between B0 and B1 (offset and variation) and SNR, CNR, and image quality were explored.
  
  
  RESULTS
  The use of the susceptibility-matched pillow led to a 43% reduction of B0 variation over the brachial plexus compared to the situation without a pillow (P < 0.05). The combination of the pillow with IB-shimming and the optimized diffusion-prepared sequence resulted in good nerve visibility, good fat suppression, no artifacts that would hinder clinical diagnosis, and a good overall quality (median scores ≥4). Reducing B0 variation was associated with SNR, CNR, and the above-mentioned scored features (P < 0.05).
  
  
  CONCLUSIONS
  The use of a susceptibility-matched pillow in combination with IB-shimming enables robust and high-quality neurography of the complete brachial plexus.
authors.affiliation: Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Jos
authors.initials: J
authors.lastname: Oudeman
authors.affiliation: Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Bram F
authors.initials: BF
authors.lastname: Coolen
authors.affiliation: Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.|Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Nijmegen, The Netherlands.|Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Valentina
authors.initials: V
authors.lastname: Mazzoli
authors.affiliation: Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Mario
authors.initials: M
authors.lastname: Maas
authors.affiliation: Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Camiel
authors.initials: C
authors.lastname: Verhamme
authors.affiliation: Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Wyger M
authors.initials: WM
authors.lastname: Brink
authors.affiliation: Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Webb
authors.affiliation: Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Nijmegen, The Netherlands.|Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Gustav J
authors.initials: GJ
authors.lastname: Strijkers
authors.affiliation: Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Aart J
authors.initials: AJ
authors.lastname: Nederveen
mesh_terms: D000328:Adult; D000465:Algorithms; D031230:Ananas; D016477:Artifacts; D001628:Beverages; D001917:Brachial Plexus / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media / Q000737:chemistry; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional; D060526:Magnetic Fields; D008297:Male; D059629:Signal-To-Noise Ratio; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: 3D turbo spin-echo; MR neurography; brachial plexus; magnetic susceptibility; peripheral nerves; shimming