Evaluation of the axillary nerve and suprascapular nerve with respect to the anatomical landmarks of shoulder surgery using zero echo time magnetic resonance imaging

There is a risk of injury to the axillary and suprascapular nerves in arthroscopic or open surgical interventions on the shoulder region. Due to its proximity to the axillary and suprascapular nerves, the glenoid cavity is an important anatomical reference point. The safety and success of the surgical procedure mainly depends on a thorough understanding of the anatomy of this region. In recent years, zero echo time sequence have been used to visualize the mineralized parts of the bone and soft tissues that cannot be adequately visualized by magnetic resonance imaging. Zero echo time sequence can produce computed tomography-like images. In this study, the relationship of the axillary and suprascapular nerves with the glenoid cavity was analyzed using zero-echo time sequence. Additionally, the distance between the inferior rim of the glenoid cavity and the axillary nerve was measured in fresh frozen cadaver section and zero echo time images. The distance between the inferior rim of the glenoid cavity with axillary nerve is 15.11±3.81 mm. The distance between the location of the suprascapular nerve in the suprascapular notch and superior rim of glenoid cavity, and its location in the spinoglenoid notch and the articular surface of glenoid cavity was determined as 28.98±3.23 mm, 13.33±2.67 mm, respectively. To the best of our knowledge, this is the first study to examine the relationship between nerve and bone using zero echo time sequence in shoulder surgery procedures. Its use as an imaging modality in preoperative planning may help to reduce iatrogenic nerve complications.