Department of Radiology, Mayo Clinic, 200 1st ST SW, Rochester, MN, 55905, USA.
Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA.
Skeletal Radiol. 2020 Jul;49(7):1135-1140. doi: 10.1007/s00256-020-03399-8. Epub 2020 Feb 24.
Identify sonographic features of the lateral femoral cutaneous nerve (LFCN) in meralgia paresthetica (MP) and report therapeutic outcomes in sonographically confirmed cases.
Retrospective review of 50 patients with clinically suspected MP and 20 controls. Ultrasounds were reviewed for characteristics of the LFCN and compared between groups. When available, MRIs were reviewed. In cases of sonographically pathologic LFCN, subsequent therapeutic interventions were recorded.
Thirty-five of the suspected MP cases (70%) had ultrasound findings suggestive of MP, 10 (20%) were negative, and in 5 (10%) the LFCN was not seen. Sonographic findings in positive cases included nerve enlargement in all cases (mean cross-sectional area 9 mm (standard deviation (SD) ± 5.59) versus 4 mm (SD ± 2.31) and 3 mm (SD ± 2.31) in negative cases and normal controls, respectively; p < 0.01), nerve hypoechogenicity (30 of 35 cases, 86%), and focal lesion (7 of 35 cases, 20%). Sixteen ultrasounds positive for MP had MRIs with only 4 (25%) reporting a concordant LFCN abnormality (enlargement or T2 hyperintensity). Twenty-five of the 35 (71%) patients with positive sonographic findings for MP had a US-guided LFCN block (local anesthetic ± corticosteroid), with 24 of 25 (96%) patients reporting immediate symptomatic improvement. Eighteen of 35 (51%) underwent LFCN neurectomy or neurolysis, all of whom experienced symptomatic improvement.
Ultrasound is a useful modality for LFCN assessment in clinically suspected MP and is more sensitive for abnormalities than MRI. Nearly all patients who received perineural analgesia and/or neurectomy or neurolysis had symptomatic improvement.
识别感觉异常性股痛（MP）中股外侧皮神经（LFCN）的超声特征，并报告经超声证实的病例的治疗结果。
回顾性分析 50 例临床疑似 MP 患者和 20 例对照者。对 LFCN 的超声特征进行回顾性分析，并比较两组之间的差异。如有可能，还会对 MRI 进行评估。对于超声表现异常的 LFCN，记录后续的治疗干预措施。
35 例疑似 MP 患者（70%）的超声检查结果提示存在 MP，10 例（20%）为阴性，5 例（10%）未见到 LFCN。阳性病例的超声表现包括神经增粗（所有病例的平均横截面积为 9mm（标准差 ± 5.59），而阴性病例和正常对照组分别为 4mm（标准差 ± 2.31）和 3mm（标准差 ± 2.31）；p < 0.01）、神经低回声（35 例中的 30 例，86%）和局灶性病变（35 例中的 7 例，20%）。16 例超声检查阳性的 MP 患者进行了 MRI 检查，只有 4 例（25%）报告存在 LFCN 异常（增粗或 T2 高信号）。35 例超声检查阳性的 MP 患者中有 25 例（71%）进行了 LFCN 超声引导阻滞（局部麻醉药 ± 皮质类固醇），其中 24 例（96%）患者报告症状立即改善。35 例中有 18 例（51%）进行了 LFCN 神经切断术或神经松解术，所有患者的症状均有改善。
超声是一种评估临床疑似 MP 中 LFCN 的有用方法，其对异常的敏感性高于 MRI。几乎所有接受神经周围镇痛和/或神经切断术或神经松解术的患者症状均有改善。
