Avneesh Chhabra MD, Presenter: Research Grant, Siemens AG Research Consultant, Siemens AG Research Grant, Integra LifeSciences Holdings Corporation Research Grant, General Electric Company Consultant, ICON plc

Jared Kasper MD, Abstract Co-Author: Nothing to Disclose

Evaluate relative merits of SHINKIE over conventional 3D inversion recovery (IR) turbo spin echo (TSE) imaging used for LS plexus MRN.

Prospectively acquired 21 consecutive LS MRN exams on 3 Tesla scanner using both 1.5mm isotropic 3DIRTSE and SHINKIE techniques were analyzed. Two trained observers evaluated all images for motion and pulsation artifacts, nerve signal to noise (SNR), contrast to noise (CNR), nerve−fat ratio, quality as well as degree of fat suppression (muscle−fat ratio) and depiction of various segments of the LS plexus.

4 exams were excluded due to prior spine surgery. Bowel motion artifacts, pulsation artifacts, inhomogeneous fat saturation and patient motion were seen in 16/17, 0/17, 17/17, 2/17 in 3DIRTSE and 0/17, 0/17, 0/17, 1/17 in SHINKIE, respectively. The p values were significant in SHINKIE for nerve SNR (<0.01), CNR (<0.01), nerve to fat (<0.01) and degree of fat saturation, muscle to fat ratio (p<0.01). Both 3D IRTSE and SHINKIE showed all LS plexus nerve roots, sciatic and femoral nerves universally. Smaller branches including obturator nerves, ilioinguinal and iliohypogastric were seen in 10/17, 5/17, 1/17 in 3DIRTSE and 17/17, 16/17, 7/17 in SHINKIE exams, respectively.

In addition to the benefit of effective vascular signal and bowel artifact suppression, the SHINKIE MRN technique demonstrates increased conspicuity of smaller LS plexus branches.  

SHINKIE sequence should be incorporated in LS plexus imaging for better nerve identification and pre-surgical planning.

Chhabra, A, Kasper, J, Shinkie (Nerve-Sheath Signal Increased with Inked Rest-Tissue Rare Imaging) — Novel 3D Isotropic MR Neurography (MRN) Technique for Lumbosacral Plexus Evaluation.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045787.html