Department of Radiology, Hopital Sud, University Hospital, 16 Boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France.
Pediatr Radiol. 2012 Aug;42(8):952-8. doi: 10.1007/s00247-012-2418-y. Epub 2012 Jul 26.
Localized hypertrophic neuropathy (LHN) of the sciatic nerve in children is a rare condition characterized by a painless neurological deficit in the sciatic nerve territory.
To demonstrate the role of MRI using a specific protocol and describe the primary findings in LHN.
Imaging in four children (age 2 years to 12 years) is presented. All children presented with lower limb asymmetry. Three had a steppage gait. LHN was confirmed by electrophysiological studies and by MRI of the whole sciatic nerve with a dedicated protocol covering the lumbar spine and the lower limb.
There were four direct MRI findings: (1) linear and focal hypertrophy with progressive enlargement of a peripheral nerve or plexus diameter, (2) abnormal hyperintensity of the nerve on T2-weighted images, (3) preserved fascicular configuration, and (4) variable enhancement after intravenous gadolinium administration. In addition there were atrophy and fatty infiltration of innervated muscles. MRI was helpful for determining the extent of lesions and in excluding peripheral nerve compression or tumour.
MRI of the whole sciatic nerve is the method of choice for diagnosing LHN of the sciatic nerve.
儿童局部性肥大性神经病（LHN）是一种罕见的疾病，其特征是坐骨神经区域出现无痛性神经功能缺损。
展示使用特定方案的 MRI 的作用，并描述 LHN 的主要发现。
呈现了 4 名儿童（年龄 2 岁至 12 岁）的影像学资料。所有儿童均表现出下肢不对称。其中 3 人出现步态蹒跚。通过电生理学研究和使用专门的方案对整个坐骨神经进行 MRI 检查（包括腰椎和下肢）来确认 LHN。
有四个直接的 MRI 发现：（1）线性和局灶性肥大，导致外周神经或神经丛直径逐渐增大，（2）T2 加权图像上的神经异常高信号，（3）保留束状结构，（4）静脉内钆给药后的可变增强。此外，还存在支配肌肉的萎缩和脂肪浸润。MRI 有助于确定病变的范围，并排除周围神经压迫或肿瘤。
整个坐骨神经的 MRI 是诊断坐骨神经 LHN 的首选方法。
