What question did this study set out to answer?

This research aims to compare the effectiveness of MENSA-NERVE and STIR-FSE sequences in brachial plexus MRN regarding vascular and fat suppression.

April 4, 2026Open Access

Comparison of Three-Dimensional Multi-Echo in Steady-State Acquisition and Short-Tau Inversion Recovery Sequences in Brachial Plexus Magnetic Resonance Neurography

Key Points

This research aims to compare the effectiveness of MENSA-NERVE and STIR-FSE sequences in brachial plexus MRN regarding vascular and fat suppression.
Retrospective analysis of 50 subjects undergoing unilateral BP MRN at 3-Tesla.
Sequential acquisition of STIR-FSE and MENSA-NERVE sequences assessed by 2 radiologists.
Evaluation of vascular suppression, fat suppression, and visualization of nerve structures using Wilcoxon signed-rank test.
MENSA-NERVE showed significantly better vascular suppression than STIR-FSE (p<0.001).
STIR-FSE was favored for fat suppression, especially at the neck-shoulder junction (p=0.05 to <0.001).
MENSA-NERVE provided clearer visuals of the suprascapular and axillary nerves (p=0.004 to <0.001).
Interrater agreement for both sequences was high, indicating consistent diagnostic results.

Abstract

BACKGROUND AND PURPOSE: The short-tau inversion recovery fast spin echo (STIR-FSE) pulse sequence is commonly used for 3D magnetic resonance neurography (MRN) of the brachial plexus (BP) due to its low B0 susceptibility and robust fat suppression. An alternative 3D acquisition is a multi-echo in steady-state acquisition (MENSA-NERVE) sequence that typically provides more robust vascular suppression, but poorer fat suppression due to its use of a water excitation pulse. MATERIALS AND METHODS: A total of 50 subjects (24 female, median age range: 34 years 14-73) who underwent unilateral BP MRN at 3-Telsa where non-contrast STIR-FSE and MENSA-NERVE were sequentially acquired and retrospectively analyzed. Sequences were assessed by 2 radiologists for vascular suppression, fat suppression, and visualization of the BP nerve roots, trunks, and cords as well as of the suprascapular nerve and axillary nerve. Pooled measurements were analyzed using the Wilcoxon signed-rank test, and agreement proportion was used to assess inter-rater/inter-sequence diagnostic agreement. RESULTS: MENSA-NERVE outperformed STIR-FSE for vascular suppression (pCONCLUSION: MENSA-NERVE provided superior vascular suppression and nerve conspicuity as compared to non-contrast STIR-FSE and with less robust fat suppression at the neck-shoulder junction and lung apex.

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