Jengojan S, Schellen C, Bodner G, Kasprian G
Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Währinger Gürtel 18-21, 1090, Wien, Österreich.
Radiologe. 2017 Mar;57(3):195-203. doi: 10.1007/s00117-017-0222-2.
Technical advances in magnetic resonance (MR) and ultrasound-based neurography nowadays facilitate the radiological assessment of the lumbosacral plexus.
Anatomy and imaging of the lumbosacral plexus and diagnostics of the most common pathologies.
Description of the clinically feasible combination of magnetic resonance imaging (MRI) and ultrasound diagnostics, case-based illustration of imaging techniques and individual advantages of MRI and ultrasound-based diagnostics for various pathologies of the lumbosacral plexus and its peripheral nerves.
High-resolution ultrasound-based neurography (HRUS) is particularly valuable for the assessment of superficial structures of the lumbosacral plexus. Depending on the examiner's experience, anatomical variations of the sciatic nerve (e. g. relevant in piriformis syndrome) as well as more subtle variations, for example as seen in neuritis, can be sonographically depicted and assessed. The use of MRI enables the diagnostic evaluation of more deeply located nerve structures, such as the pudendal and the femoral nerves. Modern MRI techniques, such as peripheral nerve tractography allow three-dimensional depiction of the spatial relationship between nerves and local tumors or traumatic alterations. This can be beneficial for further therapy planning.
The anatomy and pathology of the lumbosacral plexus can be reliably imaged by the meaningful combination of MRI and ultrasound-based high resolution neurography.
如今，磁共振（MR）和基于超声的神经成像技术进步促进了腰骶丛的放射学评估。
腰骶丛的解剖与成像以及最常见病变的诊断。
描述磁共振成像（MRI）和超声诊断在临床上可行的联合应用，通过病例说明成像技术以及MRI和基于超声的诊断对于腰骶丛及其周围神经各种病变的个体优势。
基于高分辨率超声的神经成像（HRUS）对于评估腰骶丛的浅表结构特别有价值。根据检查者的经验，坐骨神经的解剖变异（如在梨状肌综合征中相关的变异）以及更细微的变异，如神经炎中所见的变异，都可以通过超声进行描绘和评估。MRI的应用能够对更深层的神经结构，如阴部神经和股神经进行诊断评估。现代MRI技术，如周围神经纤维束成像，能够对神经与局部肿瘤或创伤性改变之间的空间关系进行三维描绘。这对进一步的治疗规划可能有益。
通过MRI和基于超声的高分辨率神经成像的合理联合应用，能够可靠地对腰骶丛的解剖结构和病变进行成像。
