Enhanced Neonatal Brachial Plexus MR Neurography: A Comparative Analysis of Compressed SENSE versus SENSE.

Background and purpose: Neonatal brachial plexus imaging faces challenges with extended scan times and motion artifacts. This study assessed whether compressed sensitivity encoding acceleration could achieve image quality comparable to conventional Sensitivity Encoding while significantly reducing scanning time, potentially enhancing diagnostic accuracy and success rates in neonatal brachial plexus imaging.

Materials and methods: 45 neonates (18 males, 27 females; mean age 14.82±9.62 days) with clinical suspicion of brachial plexus nerve injury were examined using both compressed sensitivity encoding and Sensitivity Encoding 3D Nerve VIEW sequences on a 3.0T MRI scanner. The parallel acquisition acceleration factor was 1.3 for Sensitivity Encoding and 6 for compressed sensitivity encoding. Image quality was evaluated quantitatively using signal-to-noise ratio and nerve-to-muscle contrast-to-noise ratio, and qualitatively through a five-point semiquantitative scale assessment by two senior pediatric radiologists.

Results: Compressed sensitivity encoding reduced acquisition time by approximately 30% (3:36 vs. 5:08 minutes) compared to sensitivity encoding, without compromising image quality. No significant differences were found in signal-to-noise ratio and nerveto-muscle contrast-to-noise ratio between compressed sensitivity encoding and sensitivity encoding, with equivalence testing confirming comparable image quality (signal-to-noise ratio: t(44) = 3.109, p = 0.002; nerve-to-muscle contrast-to-noise ratio: t(44) = 1.984, p = 0.03). Radiologists' subjective evaluations revealed no significant difference in image quality scores between CS and SENSE, with strong inter-rater agreement for both methods (compressed sensitivity encoding: κ = 0.773; sensitivity encoding: κ = 0.617).

Conclusions: Implementation of compressed sensitivity encoding technology in 3D Nerve VIEW sequences for neonatal brachial plexus imaging is feasible and effective, providing image quality comparable to sensitivity encoding while significantly reducing scanning time. This advancement potentially improving patient outcomes through higher success rates in imaging examinations.

Abbreviations: MRN = Magnetic resonance neurography; CS = Compressed Sensitivity Encoding; SENSE = Sensitivity Encoding; CNR = contrast-to-noise ratio; TOST = Two one-sided tests; SD = standard deviation.