Learning objectives
The aim is to present a review on the anatomy of the lumbosacral plexus nerves,
along with imaging protocols and the most common pathologies that should be recognized by the radiologist.
Background
Magnetic resonance neurography(MRN) is the direct imaging of nerves in the body by optimizing selectivity for uniqueMRIwater properties of nerves.It is high end application of MRI that requires special dedicated protocol,
targeting the nerve in question.
Clinical evaluation of peripheral neuropathies has traditionally relied on clinical examination and electro-diagnostic testing.
Recent developments in MR scanner and coil technology and the refinement of pulse sequences for increasing structural resolution have allowed imaging of fine details in healthy and diseased peripheral nerve.
MRN nicely depicts peripheral nerve...
Findings and procedure details
Normal anatomy of the lumbosacral plexus:
The lumbar and sacral plexuses are formed by the ventral rami of L1–L4 and the ventral rami of L4–S3.
Together,
via the lumbosacral trunk,
they form the lumbosacral plexus,
which innervates the lower extremity.
The lumbar plexus is formed in the psoas muscle.
It gives rise to nerves which exit either lateral (iliohypogastric,
ilioinguinal,
genitofemoral,
femoral,
and lateral femoral cutaneous nerve) or medial (obturator nerve and lumbosacral trunk) to the psoas muscle.
The sacral plexus is formed anterior to...
Conclusion
The lumbosacral plexus is a series of nerve convergences and divergences that ultimately combine into larger terminal nerves that supply the pelvis and lower extremities.
The lumbrosacral plexus is subject to a variety of insults that may lead to lumbrosacral plexopathy,
a clinical syndrome that includes motor and sensory disturbances.
Traditionally,
diagnosing lumbrosacral plexopathy relied on medical history; clinical findings; and electrodiagnostic test results,
such as electromyography,
whereas computed tomography and conventionalMRI were used to evaluate mass lesions and guide biopsies .
Often,
differentiating lumbrosacral...
Personal information
Dr Rola Zayed,M.Sc
Fellow in training,
Ain Shams University,
Cairo,
Egypt.
Email:
[email protected]
References
1. Andreisek et al.
Upper extremity peripheral neuropathies: role and impact of MR imaging on patient management.
Eur Radiol.
(2008) 18: 1953–1961
2. Avneesh Chhabra,
Lianxin Zhao,
John A.
Carrino,
et al.,
“MR Neurography: Advances,”Radiology Research and Practice,
vol.
2013,
Article ID 809568,
14 pages,
2013
3. Bäumer et al.
(2012) MR Neurography – Diagnostic Criteria to Determine Lesions of Peripheral Nerves.
Clinical Neurology.
4. Chabra A.
and Andreisek G.
Magnetic Resonance Neurography.
American Journal of Roentgenology January 2013,
Volume 200,
Number 1
5. Chabra...