Imaging of the brachial plexus modified2 (1)

ModifiedModified ImagingImaging of of thethe BrachialBrachial PlexusPlexus KATHLEEN MAILLY, RTR (MR)KATHLEEN MAILLY, RTR (MR) CARLOS TORRES ARBELÁEZ, MD.CARLOS TORRES ARBELÁEZ, MD. CARLOS TORRES ARBELÁEZ, MD.CARLOS TORRES ARBELÁEZ, MD. RAQUEL del CARPIORAQUEL del CARPIO O’DONOVAN, MDO’DONOVAN, MD McGILLMcGILL UNIVERSITY HEALTH CENTREUNIVERSITY HEALTH CENTRE MONTREAL GENERAL HOSPITAL MONTREAL GENERAL HOSPITAL DEPT OF RADIOLOGY AND DIAGNOSTIC IMAGINGDEPT OF RADIOLOGY AND DIAGNOSTIC IMAGING [...]... from axial Modified Imaging of the Brachial Plexus MODIFIED TECHNIQUE Modified Imaging of the Brachial Plexus MODIFIED TECHNIQUE Modified Imaging of the Brachial Plexus Brachial nerves are Isointense ( same intensity) to the muscles on T1W And mildly hyperintense ( increased signal ) on T2W Modified Imaging of the Brachial Plexus MODIFIED TECHNIQUE: Modified Imaging of the Brachial Plexus MODIFIED TECHNIQUE:... Plexus MODIFIED TECHNIQUE: Sagittals are planned on the good axials axials Modified Imaging of the Brachial Plexus TRADITIONAL TECHNIQUE MODIFIED TECHNIQUE Modified Imaging of the Brachial Plexus TRADITIONAL TECHNIQUE MODIFIED TECHNIQUE Modified Imaging of the Brachial Plexus TRADITIONAL TECHNIQUE MODIFIED TECHNIQUE Modified Imaging of the Brachial Plexus TRADITIONAL TECHNIQUE MODIFIED TECHNIQUE Axial.. .Imaging of the Brachial Plexus MAGNETIC RESONANCE IMAGING • Excellent soft tissue contrast resolution • Multiplanar capabilities • No ionizing radiation • DISADVANTAGE: LONG SCAN TIME Modified Imaging of the Brachial Plexus Modified scanning technique of the Brachial Plexus • Diminish cardiac pulsation artifact • Improve diagnostic quality • ADVANTAGE: REDUCED SCAN TIME Modified Imaging of the Brachial. .. 320x224 Modified Imaging of the Brachial Plexus BRACHIAL PLEXUS PROTOCOL: Parameters for FRFSE T2: • TR/TE: 4000/110 • Slice thickness/gap: 3/1 • FOV: 22 - 28 cm • Matrix: 384x256 Modified Imaging of the Brachial Plexus MODIFIED IMAGING TECHNIQUE: • LOCALIZER in 3 planes with 160 or 192 phase to better visualize anatomy anatomy • Add slices in the coronal plane depending on the size of the patient patient... of the patient patient • This is the plane you plan your axial on on Modified Imaging of the Brachial Plexus CONVENTIONAL TECHNIQUE LOCALIZER MODIFIED TECHNIQUE Normal Brachial Plexus Coronal Elongated bundles of fibers, frequently with strips of adipose tissue ( fat tissue) Modified Imaging of the Brachial Plexus Brachial nerves are Isointense ( same intensity) to the muscles on T1W And mildly hyperintense... min 17 sec Sagittal T2: 7 min 32 sec 6 min 08 sec TOTAL TIME: 41 min 22 sec 28 min 48 sec = $$$$$ Modified Imaging of the Brachial Plexus MODIFIED CORONAL IMAGES ROOTS TRUNKS CORDS DIVISION BRANCHES Modified Imaging of the Brachial Plexus MODIFIED AXIAL IMAGES Modified Imaging of the Brachial Plexus MODIFIED SAGITTAL IMAGES: Branches SCL artery ... signal ) on T2W Normal Brachial Plexus Sagittal Roots and trunks: round or oval shape, superior and posterior to the subclavian artery Divisions: dot-like structures in a triangular shaped cluster superior to the subclavian artery Cords: rounded or elongated structures adjacent to the axillary artery cords SCL vein SCLartery Modified Imaging of the Brachial Plexus TRADITIONAL IMAGING TECHNIQUE: Axials... • ADVANTAGE: REDUCED SCAN TIME Modified Imaging of the Brachial Plexus BRACHIAL PLEXUS PROTOCOL: • Images were obtained on a GE 1.5 tesla Signa Excite magnet • 8 channel neurovascular coil • 3 plane localizer • T1, T2 and optional fast stir sequences • Axial, coronal and sagittal planes Modified Imaging of the Brachial Plexus BRACHIAL PLEXUS PROTOCOL: Parameters for FSE T1: • TR/TE: 500/10 • Slice . of the Brachial Plexus Taken from Neuroimaging Clinic of North America Subclavian artery Subclavian vein Anatomy of the Brachial PlexusAnatomy of the Brachial Plexus ImagingImaging of of thethe. TIME ModifiedModified ImagingImaging of of thethe BrachialBrachial PlexusPlexus ModifiedModified scanningscanning techniquetechnique of of thethe BrachialBrachial PlexusPlexus •• DiminishDiminish cardiaccardiac pulsationpulsation artifactartifact •• DiminishDiminish cardiaccardiac pulsationpulsation artifactartifact ••. HOSPITAL DEPT OF RADIOLOGY AND DIAGNOSTIC IMAGINGDEPT OF RADIOLOGY AND DIAGNOSTIC IMAGING