Rusu Georgeta Mihaela, Curcean Andra Diana, Dudea Sorin Marian
Radiology Department, Academic Emergency County Hospital, Cluj-Napoca, Romania.
Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Med Pharm Rep. 2020 Oct;93(4):357-364. doi: 10.15386/mpr-1629. Epub 2020 Oct 25.
The study describes the femoral (FN) and sciatic nerves (SN), explored using ultrasound (US) and magnetic resonance imaging (MRI). The aims of the study are: to establish US/MRI correlations and define reference values: for the anteroposterior (AP) and mediolateral (ML) diameters and cross-sectional area (CSA) of the two nerves respectively, in well-defined anatomical measuring sites; to analyze the intraobserver variation; to define the value with least variability; to determine differences between the right-left and male-female reference values.
A prospective study was carried out on 24 healthy volunteers (11 men and 13 women). MRI scans were performed using a 1.5T system. To visualize both nerves (FN and SN), a single 3D T2 weighted acquisition was performed, in the coronal plane, with a wide FOV. For ultrasonographic examinations, a Hitachi EUB-8500 ultrasound machine, equipped with a 13 MHz linear transducer was used. The measurements were performed at well-defined anatomical locations. The mean reference values of the AP, ML diameters and CSA were calculated for femoral and sciatic nerves, both on MRI and US. The correlations between the values determined by the two techniques were analyzed. The intra-observer variation was calculated by measuring the nerves at the same anatomical location at two separate time points.
Wilcoxon matched-pairs signed rank test indicated a non-significant difference (p> 0.05) for the femoral and sciatic nerves, on both sides, except the femoral nerve ML diameter on MRI (p=0.014). The mean MRI and US reference values for the femoral nerve were calculated between the psoas and iliac muscles: FNAPMRI 4.533 ± 0.486, FNAPUS 4.800 ± 1.237, FNMLMRI 6.172 ± 1.203, FNMLUS 7.685 ± 3.338, FNCSAMRI 24.811 ± 3.394, FNCSAUS 26.285 ± 17.608. The mean MRI and US measurements for the sciatic nerve were determined under the buttock, at the level of the ischial tuberosity: SNAPMRI 5.500 ± 1.201, SNAPUS 5.975 ± 1.312, SNMLMRI 10.375 ± 2.272, SNMLUS 13.500 ± 1.661, SNCSAMRI 50.625 ± 15.373, SNCSAUS 53.631 ± 15.847. The MRI and US differences between right and left sides, both for the femoral and sciatic nerves were insignificant. In selected cases, Wilcoxon paired test indicated differences between subjects, according to their gender, both on MRI and US.
Reference values for the femoral and sciatic nerves at specific anatomical sites were identified. Side to side variation and gender related differences add to current knowledge on nerve size in young Caucasian population.
本研究描述了使用超声（US）和磁共振成像（MRI）对股神经（FN）和坐骨神经（SN）进行的探查。本研究的目的是：建立US/MRI相关性并确定参考值：分别在明确的解剖测量部位，确定两条神经的前后径（AP）、内外径（ML）和横截面积（CSA）；分析观察者内变异；确定变异最小的值；确定左右侧参考值以及男女参考值之间的差异。
对24名健康志愿者（11名男性和13名女性）进行了一项前瞻性研究。使用1.5T系统进行MRI扫描。为了显示两条神经（FN和SN），在冠状面进行单次3D T2加权采集，采用大视野。超声检查使用配备13MHz线性探头的日立EUB - 8500超声仪。测量在明确的解剖位置进行。计算股神经和坐骨神经在MRI和US上的AP、ML直径和CSA的平均参考值。分析两种技术所测值之间的相关性。通过在两个不同时间点在相同解剖位置测量神经来计算观察者内变异。
Wilcoxon配对符号秩检验表明，除了MRI上股神经的ML直径（p = 0.014）外，两侧的股神经和坐骨神经差异均无统计学意义（p > 0.05）。股神经的平均MRI和US参考值在腰大肌和髂肌之间计算得出：FNAPMRI 4.533 ± 0.486，FNAPUS 4.800 ± 1.237，FNMLMRI 6.172 ± 1.203，FNMLUS 7.685 ± 3.338，FNCSAMRI 24.811 ± 3.394，FNCSAUS 26.285 ± 17.608。坐骨神经的平均MRI和US测量值在臀部坐骨结节水平确定：SNAPMRI 5.500 ± 1.201，SNAPUS 5.975 ± 1.312，SNMLMRI 10.375 ± 2.272，SNMLUS 13.500 ± 1.661，SNCSAMRI 50.625 ± 15.373，SNCSAUS 53.631 ± 15.847。股神经和坐骨神经左右侧之间的MRI和US差异均无统计学意义。在选定病例中，Wilcoxon配对检验表明，根据性别，MRI和US上受试者之间存在差异。
确定了特定解剖部位股神经和坐骨神经的参考值。左右侧变异以及性别相关差异增加了我们对年轻白种人群神经大小的现有认识。
