Quantitative double echo steady state T2 mapping of upper extremity peripheral nerves and muscles.

ABSTRACT

Introduction: T2 mapping can characterize peripheral neuropathy and muscle denervation due to axonal damage. Three-dimensional double echo steady-state (DESS) can simultaneously provide 3D qualitative information and T2 maps with equivalent spatial resolution. However, insufficient signal-to-noise ratio may bias DESS-T2 values. Deep learning reconstruction (DLR) techniques can reduce noise, and hence may improve quantitation of high-resolution DESS-T2. This study aims to (i) evaluate the effect of DLR methods on DESS-T2 values, and (ii) to evaluate the feasibility of using DESS-T2 maps to differentiate abnormal from normal nerves and muscles in the upper extremities, with abnormality as determined by electromyography. Methods and results: Analysis of images from 25 subjects found that DLR decreased DESS-T2 values in abnormal muscles (DLR = 37.71 ± 9.11 msec, standard reconstruction = 38.56 ± 9.44 msec, p = 0.005) and normal muscles (DLR 27.18 ± 6.34 msec, standard reconstruction 27.58 ± 6.34 msec, p < 0.001) consistent with a noise reduction bias. Mean DESS-T2, both with and without DLR, was higher in abnormal nerves (abnormal = 75.99 ± 38.21 msec, normal = 35.10 ± 9.78 msec, p < 0.001) and muscles (abnormal = 37.71 ± 9.11 msec, normal = 27.18 ± 6.34 msec, p < 0.001). A higher DESS-T2 in muscle was associated with electromyography motor unit recruitment (p < 0.001). Discussion: These results suggest that quantitative DESS-T2 is improved by DLR and can differentiate the nerves and muscles involved in peripheral neuropathies from those uninvolved.