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The goal of this observational study is to evaluate whether optimized high-resolution MRI can better visualize very fine nerves in the cervical spine and neck region compared to standard MRI. The main question it aims to answer is:
Can high-resolution MRI reliably show small nerves and potentially detect their injuries or diseases that are often invisible on conventional MRI scans?
Participants will come once to Balgrist University Hospital for a one-hour visit. They will fill out a questionnaire and have a single 30-minute MRI scan of the cervical spine without contrast.
Diseases and injuries of the nerves in the area of the cervical spine and neck region are among the most common causes of pain in the neck, shoulder, and arm areas. To clarify the cause of the pain, an MRI examination of the neck region is therefore very often requested in order to visualize the nerves. However, some very fine nerves - in particular the smaller branches of the cervical nerves - are so thin that they can usually only be visualized incompletely or not at all reliably with conventional MRI techniques. As a result, injuries or diseases of some nerves frequently remain undetected, even though these nerves perform important motor functions - for example, the movement of the shoulder, the arm, or (in rare cases) also the diaphragm. Through modified and technically advanced MRI protocols (in particular high-resolution MR neurography), significantly better images can now be generated.
This study therefore investigates whether these special techniques can also clearly depict even very small nerves, so that these techniques can be applied in the future to patients with pathological changes and these changes can be better identified.
Participation involves a single visit to Balgrist University Hospital. The time commitment is one hour. Participants receive oral information about the project, complete a short questionnaire, and subsequently undergo the MRI examination. The time spent in the MRI scanner is approximately 30 minutes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Healthy volunteers |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| High-resolution three-dimensional magnetic resonance neurography protocols | Diagnostic Test | Clinical standard three-dimensional magnetic resonance neurography sequences with high spatial resolution |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of visible small-caliber nerve segments | Visibility of small-caliber cervical nerves (phrenic, spinal accessory, dorsal scapular, vagus nerve) per segment (proximal, midsegment, distal) on both sides (left/right) per volunteer. Two board-certified radiologists with experience in MR Neurography will independently determine visibility (binary score: 0 = not visible, 1 = visible). Visibility is defined as continuous depiction of the nerve segment over its entire length with signal intensity clearly distinguishable from background tissue. | Within 12 weeks after MRI acquisition during radiological readout |
| Measure | Description | Time Frame |
|---|---|---|
| Image quality score across different acceleration factors | Image quality of small-caliber cervical nerves across varying acceleration factors will be independently assessed by two radiologists using a 4-point Likert scale (0 = poor/non-diagnostic, 2 = moderate, 3 = good, 4 = excellent). | Within 12 weeks after MRI acquisition during radiological readout |
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Inclusion Criteria:
- written consent to agree to participate in this study
Exclusion Criteria:
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Healthy volunteers
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Frederik Abel, MD | Contact | +41 44 386 33 27 | frederik.abel@balgrist.ch | |
| Reto Sutter, MD | Contact | +41 44 386 33 08 | reto.sutter@balgrist.ch |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Balgrist University Hospital | Zurich | 8008 | Switzerland |
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| Inter-reader agreement for visibility and image quality | Reliability of visibility and image quality of small-caliber cervical nerves and nerve segments will be assessed by inter-reader agreement. | Within 12 weeks after MRI acquisition during radiological readout |
| Frequency of anatomic variants | Frequency of anatomical variants of small-caliber cervical nerves, reported as percentage of volunteers. | Within 12 weeks after MRI acquisition during radiological readout |