Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Skeletal Radiol. 2013 Jun;42(6):803-8. doi: 10.1007/s00256-012-1557-4. Epub 2013 Jan 11.
To assess the diagnostic accuracy and observer performance of 3-Tesla magnetic resonance neurography (MRN) in the evaluation of meralgia paresthetica (MP).
Two independent readers were blinded to the clinical diagnosis and evaluated the MRN studies of the pelvis of 11 patients with MP and 28 control participants. In each study, the lateral femoral cutaneous nerves were assessed for signal alteration and/or neuroma formation, indicating lateral femoral cutaneous neuropathy, at various levels along their course. Intra- and inter-observer reliability was evaluated.
Both readers exhibited substantial intraobserver agreement in detecting signal alterations and neuroma formation of the lateral femoral cutaneous nerve (LFCN). The readers demonstrated moderate interobserver agreement in detecting signal alteration of the LFCN and poor interobserver agreement in diagnosing neuroma formation. Sensitivity, specificity, positive predictive value, and negative predictive value of LFCN neuropathy diagnosis were ≥ 71 % and ≥ 94 % for both readers respectively. The diagnostic test accuracy was ≥ 90 % for both readers.
3-Tesla MRN provides reliable and accurate diagnostic evaluation of meralgia paresthetica.
评估 3T 磁共振神经成像(MRN)在评估感觉异常性股痛(MP)中的诊断准确性和观察者表现。
两位独立的读者对临床诊断不了解,并评估了 11 例 MP 患者和 28 例对照参与者的骨盆 MRN 研究。在每项研究中,沿其路径的各个水平评估外侧股皮神经的信号改变和/或神经瘤形成,表明外侧股皮神经病变。评估了内部和观察者之间的可靠性。
两位读者在检测外侧股皮神经(LFCN)的信号改变和神经瘤形成方面均表现出显著的内部观察者一致性。读者在检测 LFCN 的信号改变方面表现出中度的观察者间一致性,而在诊断神经瘤形成方面则表现出较差的观察者间一致性。对于两位读者,LFCN 神经病诊断的敏感性、特异性、阳性预测值和阴性预测值均≥71%和≥94%。对于两位读者,诊断测试的准确性均≥90%。
3T MRN 为感觉异常性股痛提供了可靠和准确的诊断评估。