Neufeld Ethan A, Shen Peter Yi, Nidecker Anna E, Runner Gabriel, Bateni Cyrus, Tse Gary, Chin Cynthia
University of California Davis Medical Center, Department of Radiology, 4860 Y Street Suite 3100, Sacramento, CA, 95817.
University of California San Francisco Medical Center, Department of Radiology, 505 Parnassus Avenue, M-391, San Francisco, CA, 94143-0628.
J Neuroimaging. 2015 Sep-Oct;25(5):691-703. doi: 10.1111/jon.12253. Epub 2015 May 1.
The lumbosacral plexus is a complex anatomic area that serves as the conduit of innervation and sensory information to and from the lower extremities. It is formed by the ventral rami of the lumbar and sacral spine which then combine into larger nerves serving the pelvis and lower extremities. It can be a source of severe disability and morbidity for patients when afflicted with pathology. Patients may experience motor weakness, sensory loss, and/or debilitating pain. Primary neurologic processes can affect the lumbosacral plexus in both genetic and acquired conditions and typically affect the plexus and nerves symmetrically. Additionally, its unique relationship to the pelvic musculature and viscera render it vulnerable to trauma, infection, and malignancy. Such conditions are typically proceeded by a known history of trauma or established pelvic malignancy or infection. Magnetic resonance imaging is an invaluable tool for evaluation of the lumbosacral plexus due to its anatomic detail and sensitivity to pathologic changes. It can identify the cause for disability, indicate prognosis for improvement, and be a tool for delivery of interventions. Knowledge of proper MR protocols and imaging features is key for appropriate and timely diagnosis. Here we discuss the relevant anatomy of the lumbosacral plexus, appropriate imaging techniques for its evaluation, and discuss the variety of pathologies that may afflict it.
腰骶丛是一个复杂的解剖区域，是下肢神经支配和感觉信息进出的通道。它由腰椎和骶椎的前支组成，这些前支随后合并成支配骨盆和下肢的较大神经。当患有病变时，它可能成为患者严重残疾和发病的根源。患者可能会出现运动无力、感觉丧失和/或使人衰弱的疼痛。原发性神经过程可在遗传和后天性疾病中影响腰骶丛，且通常对称地影响丛和神经。此外，它与盆腔肌肉组织和内脏的独特关系使其易受创伤、感染和恶性肿瘤的影响。此类情况通常有已知的创伤史或已确诊的盆腔恶性肿瘤或感染史。磁共振成像因其解剖细节和对病理变化的敏感性，是评估腰骶丛的一项非常重要的工具。它可以确定残疾的原因，提示改善的预后，并作为实施干预的一种手段。了解正确的磁共振成像方案和成像特征是进行恰当及时诊断的关键。在此，我们将讨论腰骶丛的相关解剖结构、评估其的合适成像技术，并探讨可能影响它的各种病变。
