Larkman Neal, Lefebvre Guillaume, Jacques Thibault, Demondion Xavier, Cotten Hervé, Cotten Anne
Radiology Department, Harrogate District Hospital, Harrogate, UK.
Service de radiologie et imagerie musculosquelettique, CCIAL, CHRU, Lille, France.
Br J Radiol. 2017 Aug;90(1077):20170031. doi: 10.1259/bjr.20170031. Epub 2017 Jul 14.
The aim of our study is to demonstrate that increased T signal on MRI could be due to intraneural vessels in asymptomatic individuals, and may therefore be a normal finding.
An initial anatomic cadaveric study was undertaken to gain a better understanding of the vascular supply of the proximal sciatic nerve. Secondly, a retrospective study of MR imaging of patients without sciatic symptoms was performed to assess the prevalence of intraneural vessels, defined as hyperintensity on at least three consecutive slices on both T and gadolinium enhanced T weighted imaging, visible on routine MSK pelvic imaging.
The anatomical study demonstrated a relatively abundant blood supply in the peri-ischiatic region. In the MR study, 20/76 (26%) patients showed visible intraneural vessels. More than one intraneural vessel was depicted in two of the sciatic nerves. Direct branching between the extrinsic and intrinsic systems was seen in only five cases.
Normal intraneural vessels can frequently be seen within the sciatic nerve on routine musculoskeletal pelvic imaging. Advances in knowledge: T hyperintensity in the proximal sciatic nerve can be due to intraneural vessels and should not necessarily be reported as abnormal.
我们研究的目的是证明，在无症状个体中，MRI上T信号增强可能是由于神经内血管所致，因此可能是正常表现。
首先进行解剖学尸体研究，以更好地了解坐骨神经近端的血管供应。其次，对无坐骨神经症状患者的磁共振成像进行回顾性研究，以评估神经内血管的发生率，神经内血管定义为在T加权成像和钆增强T加权成像上至少连续三层出现高信号，在常规肌肉骨骼骨盆成像上可见。
解剖学研究表明，坐骨周围区域血供相对丰富。在磁共振研究中，20/76（26%）的患者可见神经内血管。在两条坐骨神经中，有两条描绘出不止一条神经内血管。仅在5例中观察到外部和内部系统之间的直接分支。
在常规肌肉骨骼骨盆成像中，坐骨神经内常可见正常神经内血管。知识进展：坐骨神经近端的T高信号可能是由于神经内血管所致，不一定应报告为异常。
