Which pulse sequence is most likely to cause peripheral nerve stimulation?

The pulse sequence that is most likely to cause peripheral nerve stimulation is diffusion-weighted imaging (DWI). This occurs primarily due to the use of rapid gradient switching that is characteristic of diffusion-weighted sequences, which can induce eddy currents in the conductive tissues of the body. These gradients create strong magnetic fields that vary rapidly, leading to the potential for unwanted stimulation of peripheral nerves, especially in areas where these gradients are particularly strong.

In contrast, the other pulse sequences, such as GRASS (Gradient Recalled Acquisition in Steady State), FLAIR (Fluid Attenuation Inversion Recovery), and fast spin echo, typically have different operational parameters that do not emphasize rapid gradient switching to the same extent. While all MRI sequences can potentially cause some level of nerve stimulation, it is the specific design and gradient application in DWI that elevates the risk of peripheral nerve stimulation compared to the others.