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对疼痛和受压神经的影像学检查:下肢

Imaging on the painful and compressed nerve: lower extremity.

作者信息

Bordalo Marcelo

机构信息

Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar.

出版信息

Int Orthop. 2025 Apr;49(4):919-924. doi: 10.1007/s00264-025-06419-1. Epub 2025 Jan 28.

DOI:10.1007/s00264-025-06419-1
PMID:39873711
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11971157/
Abstract

Entrapment neuropathies of the lower extremity are often underdiagnosed due to limitations in clinical examination and electrophysiological testing. Advanced imaging techniques, particularly MR neurography and high-resolution ultrasonography (US), have significantly improved the evaluation and diagnosis of these conditions by enabling precise visualization of nerves and their surrounding anatomical structures. This review focuses on the imaging features of compressive neuropathies affecting the lumbosacral plexus and its branches, including the femoral, obturator, sciatic, common peroneal, and tibial nerves. Key conditions such as meralgia paraesthetica, piriformis syndrome, and tarsal tunnel syndrome are discussed, highlighting findings such as nerve thickening, T2 hypersignal, fascicular changes, and associated muscle denervation patterns. The ability to detect structural causes, including anatomical variations, fibrous bands, and space-occupying lesions, underscores the value of these imaging modalities in facilitating early diagnosis, guiding therapeutic interventions, and improving patient outcomes.

摘要

由于临床检查和电生理测试存在局限性,下肢的卡压性神经病常常被漏诊。先进的成像技术,尤其是磁共振神经成像和高分辨率超声检查,通过能够精确显示神经及其周围的解剖结构,显著改善了对这些病症的评估和诊断。本综述聚焦于影响腰骶丛及其分支(包括股神经、闭孔神经、坐骨神经、腓总神经和胫神经)的压迫性神经病的成像特征。讨论了关键病症,如感觉异常性股痛、梨状肌综合征和跗管综合征,突出了神经增粗、T2高信号、束状改变以及相关肌肉失神经模式等表现。检测包括解剖变异、纤维束带和占位性病变在内的结构病因的能力,强调了这些成像方式在促进早期诊断、指导治疗干预和改善患者预后方面的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded5/11971157/31ed87824bdf/264_2025_6419_Fig10_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded5/11971157/3a658bd024ef/264_2025_6419_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded5/11971157/31ed87824bdf/264_2025_6419_Fig10_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded5/11971157/cdee33f5a288/264_2025_6419_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded5/11971157/f2c5ee77f92c/264_2025_6419_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded5/11971157/08ebf4264304/264_2025_6419_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded5/11971157/506f923fad47/264_2025_6419_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded5/11971157/a090e0353214/264_2025_6419_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded5/11971157/4ffb899b1cb5/264_2025_6419_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded5/11971157/b8106792b90e/264_2025_6419_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded5/11971157/116b21c274eb/264_2025_6419_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded5/11971157/3a658bd024ef/264_2025_6419_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded5/11971157/31ed87824bdf/264_2025_6419_Fig10_HTML.jpg

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本文引用的文献

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