|ECR 2019 / C-1904|
|MR Neurography:an emerging modality in the evaluation of the lumbosacral plexus and sciatic lesions|
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 conventional MRI were used to evaluate mass lesions and guide biopsies .
Often, differentiating lumbrosacral plexopathy from spine-related abnormalities is a clinical dilemma. Electrodiagnostic testing provides limited evaluation of the lumbrosacral plexus because of the deep location of nerves and the variable innervation of regional muscles. Depiction of the exact location, extent, cause, and character of plexopathy is often possible only at MRN.
In recent years, MRN has been increasingly used to evaluate patients with suspected or established lumbrosacral plexopathy and help confirm the diagnosis or provide anatomic information should surgical intervention be necessary. Although the sciatic nerve (the largest of the lumbrosacral plexus branches) has been extensively studied at MRN , and mass lesions involving the lumbrosacral plexus have been described in scattered case reports, there is a relative paucity of literature describing the MR neurographic features of other abnormalities of the lumbrosacral plexus and its peripheral branches.
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