Lewis Aaron M, Layzer Robert, Engstrom J W, Barbaro Nicholas M, Chin Cynthia T
Department of Neurology, University of California, San Francisco, USA.
Arch Neurol. 2006 Oct;63(10):1469-72. doi: 10.1001/archneur.63.10.1469.
Sciatica without evidence of lumbosacral root compression is often attributed to piriformis syndrome. However, specific diagnostic tools have not been available to demonstrate sciatic nerve entrapment by the piriformis muscle.
To evaluate the use of magnetic resonance (MR) neurography in identifying abnormalities of the sciatic nerve in patients with unexplained sciatica.
Case series from a retrospective medical record review.
Fourteen patients with sciatic distribution pain and normal results on MR imaging for lumbosacral radiculopathy were referred for MR neurography of the lumbosacral plexus and sciatic nerves.
In 12 patients, MR neurography demonstrated increased fluid-attenuated inversion recovery signal in the ipsilateral sciatic nerve. In most patients, this abnormal signal was seen at the sciatic notch, at or just inferior to the level of the piriformis muscle. To date, 4 patients have undergone surgical decompression, with excellent relief of symptoms in 3 of them.
Magnetic resonance neurography often identifies an abnormal increased signal in the proximal sciatic nerve in patients with extraspinal sciatica and allows more accurate diagnosis of sciatic nerve entrapment in suspected cases.
无腰骶神经根受压证据的坐骨神经痛常归因于梨状肌综合征。然而，尚无特定的诊断工具可用于显示梨状肌对坐骨神经的卡压。
评估磁共振（MR）神经造影在不明原因坐骨神经痛患者中识别坐骨神经异常的应用。
回顾性病历审查的病例系列。
14例有坐骨神经分布区疼痛且腰骶神经根病的MR成像结果正常的患者被转诊进行腰骶丛和坐骨神经的MR神经造影。
12例患者中，MR神经造影显示同侧坐骨神经的液体衰减反转恢复信号增强。在大多数患者中，这种异常信号见于坐骨切迹，在梨状肌水平或其稍下方。迄今为止，4例患者接受了手术减压，其中3例症状得到明显缓解。
磁共振神经造影常可发现脊柱外坐骨神经痛患者近端坐骨神经的异常信号增强，并有助于在疑似病例中更准确地诊断坐骨神经卡压。
