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Research ArticlePERIPHERAL NERVOUS SYSTEM

3D MR Neurography of the Lumbosacral Plexus: Obtaining Optimal Images for Selective Longitudinal Nerve Depiction

G. Cho Sims, E. Boothe, R. Joodi and A. Chhabra
American Journal of Neuroradiology November 2016, 37 (11) 2158-2162; DOI: https://doi.org/10.3174/ajnr.A4879
G. Cho Sims
aFrom the Department of Musculoskeletal Radiology, University of Texas Southwestern Medical Center, Dallas, Texas.
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E. Boothe
aFrom the Department of Musculoskeletal Radiology, University of Texas Southwestern Medical Center, Dallas, Texas.
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R. Joodi
aFrom the Department of Musculoskeletal Radiology, University of Texas Southwestern Medical Center, Dallas, Texas.
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A. Chhabra
aFrom the Department of Musculoskeletal Radiology, University of Texas Southwestern Medical Center, Dallas, Texas.
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Abstract

BACKGROUND AND PURPOSE: The number of centers currently performing 3D fat-suppressed isotropic imaging is limited. If the angular orientations of the major lumbosacral plexus nerves on 3D isotropic MR neurography could be determined, similar planes could be prescribed during acquisition of 2D or 3D nonisotropic techniques for optimal depiction of various nerves. Our aim was to determine oblique sagittal and coronal angular measurements for longitudinal depiction of lumbosacral plexus nerves. Interobserver and intraobserver performance and mean calibers of sciatic and femoral nerves were also determined.

MATERIALS AND METHODS: A consecutive series of lumbosacral plexus MR neurography examinations with 3D nerve-selective imaging performed during a 10-month period on a 3T scanner were evaluated. Two observers performed reconstructions and angular measurements. Sciatic and femoral nerve diameters were measured. Descriptive statistics and intraclass correlation coefficient correlations were used.

RESULTS: There were 52 subjects, 11 men and 41 women. Mean sagittal thecal sac angles for coronal demonstration of lumbosacral plexus nerve roots from L1 to S1 for 2 independent observers measured 13.58° ± 2.87° and 13.61° ± 2.18°. Mean sagittal femoral nerve angles were 27.78° ± 4.81° and 28.94° ± 4.49°, and mean sagittal sciatic nerve angles were −10.7° ± 3.75° and −11.82° ± 2.87°. Coronal angular measurements of the femoral and sciatic nerves were similar. The intraclass correlation coefficient was moderate (0.582–0.671) for interobserver performance. For intraobserver performance among various angular measurements, the intraclass correlation coefficient was moderate to good (0.586–0.788). Femoral nerve caliber on MR imaging was almost half that of the sciatic nerve. Mean right femoral nerve thickness was 4.52 ± 1.11 mm and 4.85 ± 0.64 mm for the 2 observers, and mean left femoral nerve thickness was 4.48 ± 0.97 mm and 4.94 ± 0.57 mm. Mean right sciatic nerve thickness was 9.71 ± 1.76 mm and 9.94 ± 0.83 mm, and mean left sciatic nerve thickness was 10.03 ± 1.71 mm and 9.98 ± 0.99 mm.

CONCLUSIONS: Angular lumbosacral plexus measurements aid in the prescription of different planes on MR imaging for the optimal longitudinal demonstration of nerves.

ABBREVIATIONS:

ICC
intraclass correlation coefficient
LS
lumbosacral
SHINKEI
nerve-SHeath signal increased with INKed rest-tissue rarE Imaging
  • © 2016 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 37 (11)
American Journal of Neuroradiology
Vol. 37, Issue 11
1 Nov 2016
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Cite this article
G. Cho Sims, E. Boothe, R. Joodi, A. Chhabra
3D MR Neurography of the Lumbosacral Plexus: Obtaining Optimal Images for Selective Longitudinal Nerve Depiction
American Journal of Neuroradiology Nov 2016, 37 (11) 2158-2162; DOI: 10.3174/ajnr.A4879

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3D MR Neurography of the Lumbosacral Plexus: Obtaining Optimal Images for Selective Longitudinal Nerve Depiction
G. Cho Sims, E. Boothe, R. Joodi, A. Chhabra
American Journal of Neuroradiology Nov 2016, 37 (11) 2158-2162; DOI: 10.3174/ajnr.A4879
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