OBJECTIVE: The sciatic nerve may normally exhibit mild T2 hyperintensity in MR neurography (MRN) images, rendering assessment of sciatic neuropathy difficult. The purpose of this case-control study was to evaluate whether a quantitative and qualitative analysis of the sciatic nerves and regional skeletal muscles increases the accuracy of MRN in detecting sciatic neuropathy. MATERIALS AND METHODS: We retrospectively reviewed the MRN studies of the pelvis and thighs of 34 subjects (12 men and 22 women; mean [± SD] age, 50 ± 15 years), of which 17 had a final diagnosis of sciatic neuropathy according to electrodiagnostic or surgical confirmation, and 17 had no evidence of sciatic neuropathy and served as control subjects. On each side, the sciatic nerves were evaluated for signal intensity (SI), size, course, and fascicular shape, whereas the regional skeletal muscles were evaluated for edema, fatty replacement, and atrophy. In addition, the nerve-to-vessel SI ratio was registered for each side at the same time and 8 months later. RESULTS: The sciatic nerves of the abnormal sides exhibited higher nerve-to-vessel SI ratios and higher incidences of T2 hyperintensity, enlargement, and abnormal fascicular shape compared to the nerves of the normal sides. The regional muscles of the abnormal sides demonstrated a higher grade of fatty infiltration and higher frequencies of edema and atrophy. A cutoff value of nerve-to-vessel SI ratio of 0.89 exhibited high sensitivity and specificity in predicting sciatic neuropathy. Calculation of the nerve-to-vessel SI ratio demonstrated excellent inter- and intraobserver reliability. CONCLUSION: Both qualitative and quantitative criteria should be used to suggest the MRN diagnosis of sciatic neuropathy.
OBJECTIVE: The sciatic nerve may normally exhibit mild T2 hyperintensity in MR neurography (MRN) images, rendering assessment of sciatic neuropathy difficult. The purpose of this case-control study was to evaluate whether a quantitative and qualitative analysis of the sciatic nerves and regional skeletal muscles increases the accuracy of MRN in detecting sciatic neuropathy. MATERIALS AND METHODS: We retrospectively reviewed the MRN studies of the pelvis and thighs of 34 subjects (12 men and 22 women; mean [± SD] age, 50 ± 15 years), of which 17 had a final diagnosis of sciatic neuropathy according to electrodiagnostic or surgical confirmation, and 17 had no evidence of sciatic neuropathy and served as control subjects. On each side, the sciatic nerves were evaluated for signal intensity (SI), size, course, and fascicular shape, whereas the regional skeletal muscles were evaluated for edema, fatty replacement, and atrophy. In addition, the nerve-to-vessel SI ratio was registered for each side at the same time and 8 months later. RESULTS: The sciatic nerves of the abnormal sides exhibited higher nerve-to-vessel SI ratios and higher incidences of T2 hyperintensity, enlargement, and abnormal fascicular shape compared to the nerves of the normal sides. The regional muscles of the abnormal sides demonstrated a higher grade of fatty infiltration and higher frequencies of edema and atrophy. A cutoff value of nerve-to-vessel SI ratio of 0.89 exhibited high sensitivity and specificity in predicting sciatic neuropathy. Calculation of the nerve-to-vessel SI ratio demonstrated excellent inter- and intraobserver reliability. CONCLUSION: Both qualitative and quantitative criteria should be used to suggest the MRN diagnosis of sciatic neuropathy.
Authors: Vibhor Wadhwa; Rashmi S Thakkar; Nicholas Maragakis; Ahmet Höke; Charlotte J Sumner; Thomas E Lloyd; John A Carrino; Allan J Belzberg; Avneesh Chhabra Journal: Skeletal Radiol Date: 2012-03-13 Impact factor: 2.199
Authors: Kenneth C Wang; Aditya R Salunkhe; James J Morrison; Pearlene P Lee; José L V Mejino; Landon T Detwiler; James F Brinkley; Eliot L Siegel; Daniel L Rubin; John A Carrino Journal: Radiographics Date: 2015 Jan-Feb Impact factor: 5.333
Authors: Avneesh Chhabra; Allan J Belzberg; Gedge D Rosson; Gaurav K Thawait; M Chalian; Sahar J Farahani; Jaimie T Shores; Gene Deune; Shar Hashemi; Shrey K Thawait; Ty K Subhawong; John A Carrino Journal: Eur Radiol Date: 2015-09-22 Impact factor: 5.315
Authors: Filippo Del Grande; Michael Aro; Sahar Jalali Farahani; John Wilckens; Andrew Cosgarea; John A Carrino Journal: Skeletal Radiol Date: 2014-10-10 Impact factor: 2.199