Moore K R, Tsuruda J S, Dailey A T
Department of Radiology, Section of Neuroradiology, University of Utah School of Medicine, Salt Lake City 84132, USA.
AJNR Am J Neuroradiol. 2001 Apr;22(4):786-94.
Fifteen patients with neuropathic leg pain referable to the lumbosacral plexus or sciatic nerve underwent high-resolution MR neurography. Thirteen of the patients also underwent routine MR imaging of the lumbar segments of the spinal cord before undergoing MR neurography. Using phased-array surface coils, we performed MR neurography with T1-weighted spin-echo and fat-saturated T2-weighted fast spin-echo or fast spin-echo inversion recovery sequences, which included coronal, oblique sagittal, and/or axial views. The lumbosacral plexus and/or sciatic nerve were identified using anatomic location, fascicular morphology, and signal intensity as discriminatory criteria. None of the routine MR imaging studies of the lumbar segments of the spinal cord established the cause of the reported symptoms. Conversely, MR neurography showed a causal abnormality accounting for the clinical findings in all 15 cases. Detected anatomic abnormalities included fibrous entrapment, muscular entrapment, vascular compression, posttraumatic injury, ischemic neuropathy, neoplastic infiltration, granulomatous infiltration, neural sheath tumor, postradiation scar tissue, and hypertrophic neuropathy.
15例因腰骶丛或坐骨神经病变导致腿部神经病理性疼痛的患者接受了高分辨率磁共振神经成像检查。其中13例患者在进行磁共振神经成像检查前还接受了脊髓腰段的常规磁共振成像检查。我们使用相控阵表面线圈，采用T1加权自旋回波和脂肪饱和T2加权快速自旋回波或快速自旋回波反转恢复序列进行磁共振神经成像检查，检查包括冠状面、斜矢状面和/或轴位视图。根据解剖位置、束状形态和信号强度作为鉴别标准来识别腰骶丛和/或坐骨神经。脊髓腰段的所有常规磁共振成像检查均未明确报告症状的病因。相反，磁共振神经成像显示在所有15例病例中均存在导致临床症状的异常情况。检测到的解剖学异常包括纤维性卡压、肌肉性卡压、血管压迫、创伤后损伤、缺血性神经病变、肿瘤浸润、肉芽肿浸润、神经鞘瘤、放疗后瘢痕组织和肥厚性神经病变。
