Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Role of MR Neurography for Evaluation of the Lumbosacral Plexus: A Scoping Review

요천추 신경총에 대한 자기공명신경조영술의 역할: 주제 범위 문헌고찰

  • Seon Gyeong Kim (Department of Radiology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Joon-Yong Jung (Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • 김선경 (가톨릭대학교 의과대학 여의도성모병원 영상의학과) ;
  • 정준용 (가톨릭대학교 의과대학 서울성모병원 영상의학과)
  • Received : 2022.01.02
  • Accepted : 2022.08.25
  • Published : 2022.11.01
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Abstract

Purpose MR neurography (MRN) is an imaging technique optimized to visualize the peripheral nerves. This review aimed to discover an optimized protocol for MRN of the lumbosacral plexus (LSP) and identify evidence for the clinical benefit of lumbosacral plexopathies. Materials and Methods We performed a systematic search of the two medical databases until September 2021. 'Magnetic resonance imaging', 'lumbosacral plexus', 'neurologic disease', or equivalent terms were used to search the literature. We extracted information on indications, MRN protocols for LSP, and clinical efficacy from 55 studies among those searched. Results MRN of the LSP is useful for displaying the distribution of peripheral nerve disease, guiding perineural injections, and assessing extraspinal causes of sciatica. Three-dimensional short-tau inversion recovery turbo spin-echo combined with vascular suppression is the mainstay of MRN. Conclusion Future work on the MRN of LSP should be directed to technical maturation and clinical validation of efficacy.

목적 자기공명신경조영술은 말초신경을 시각화하는 데 최적화된 영상 기법이다. 본 주제 범위 문 헌고찰에서는 요천추신경총에서 자기공명신경조영술의 프로토콜을 조사하고, 요추신경총 질환 환자에서 자기공명신경조영술의 임상적 이득에 대해 고찰하고자 한다. 대상과 방법 두 개의 의료 데이터베이스에서 2021년 9월까지 영문으로 출판된 논문에 대해 체계적 문헌검색을 수행하였다. 'Magnetic resonance Imaging', 'lumbosacral plexus', 'neurologic disease'를 포함하는 55편의 논문을 분석하였다. 결과 요천추신경총의 자기공명신경조영술은 말초 신경 질환의 분포 확인, 신경 주변 주사시 유도, 좌골신경통 환자에서는 척추외 원인 평가에 유용하였다. 혈관억제 기법이 적용된 3차원 단시간 반전회복 고속 스핀에코 영상이 주된 자기공명신경조영술 기법이었다. 결론 향후 요천추신경총의 자기공명신경조영술에 대한 기술적 성숙과 임상적 유용성에 대한 검증이 필요하다.

Keywords

References

  1. Tarulli AW, Raynor EM. Lumbosacral radiculopathy. Neurol Clin 2007;25:387-405
  2. Laughlin RS, Dyck PJ. Electrodiagnostic testing in lumbosacral plexopathies. Phys Med Rehabil Clin N Am 2013;24:93-105
  3. Howe FA, Filler AG, Bell BA, Griffiths JR. Magnetic resonance neurography. Magn Reson Med 1992;28:328-338
  4. Chhabra A, Subhawong TK, Bizzell C, Flammang A, Soldatos T. 3T MR neurography using three-dimensional diffusion-weighted PSIF: technical issues and advantages. Skeletal Radiol 2011;40:1355-1360
  5. Soldatos T, Andreisek G, Thawait GK, Guggenberger R, Williams EH, Carrino JA, et al. High-resolution 3-T MR neurography of the lumbosacral plexus. Radiographics 2013;33:967-987
  6. Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 2018;169:467-473
  7. Liang W, Han B, Hai Y, Yin P, Chen Y, Zou C. Diffusion tensor imaging with fiber tracking provides a valuable quantitative and clinical evaluation for compressed lumbosacral nerve roots: a systematic review and meta-analysis. Eur Spine J 2021;30:818-828
  8. Delaney H, Bencardino J, Rosenberg ZS. Magnetic resonance neurography of the pelvis and lumbosacral plexus. Neuroimaging Clin N Am 2014;24:127-150
  9. Grant GA, Goodkin R, Maravilla KR, Kliot M. MR neurography: diagnostic utility in the surgical treatment of peripheral nerve disorders. Neuroimaging Clin N Am 2004;14:115-133
  10. Eastlack J, Tenorio L, Wadhwa V, Scott K, Starr A, Chhabra A. Sciatic neuromuscular variants on MR neurography: frequency study and interobserver performance. Br J Radiol 2017;90:20170116
  11. Dessouky R, Khaleel M, Khalifa DN, Tantawy HI, Chhabra A. Magnetic resonance neurography of the lumbosacral plexus in failed back surgery syndrome. Spine (Phila Pa 1976) 2018;43:839-847
  12. Wadhwa V, Hamid AS, Kumar Y, Scott KM, Chhabra A. Pudendal nerve and branch neuropathy: magnetic resonance neurography evaluation. Acta Radiol 2017;58:726-733
  13. Ly J, Scott K, Xi Y, Ashikyan O, Chhabra A. Role of 3 tesla MR neurography and CT-guided injections for pudendal neuralgia: analysis of pain response. Pain Physician 2019;22:E333-E344
  14. Fritz J, Bizzell C, Kathuria S, Flammang AJ, Williams EH, Belzberg AJ, et al. High-resolution magnetic resonance-guided posterior femoral cutaneous nerve blocks. Skeletal Radiol 2013;42:579-586
  15. Fritz J, Dellon AL, Williams EH, Rosson GD, Belzberg AJ, Eckhauser FE. Diagnostic accuracy of selective 3-T MR neurography-guided retroperitoneal genitofemoral nerve blocks for the diagnosis of genitofemoral neuralgia. Radiology 2017;285:176-185
  16. Chhabra A, Carrino JA, Farahani SJ, Thawait GK, Sumner CJ, Wadhwa V, et al. Whole-body MR neurography: prospective feasibility study in polyneuropathy and Charcot-Marie-Tooth disease. J Magn Reson Imaging 2016;44:1513-1521
  17. Su X, Kong X, Lu Z, Zhou M, Wang J, Liu X, et al. Use of magnetic resonance neurography for evaluating the distribution and patterns of chronic inflammatory demyelinating polyneuropathy. Korean J Radiol 2020;21:483-493
  18. Chhabra A, Rozen S, Scott K. Three-dimensional MR neurography of the lumbosacral plexus. Semin Musculoskelet Radiol 2015;19:149-159
  19. Chhabra A, Flammang A, Padua A Jr, Carrino JA, Andreisek G. Magnetic resonance neurography: technical considerations. Neuroimaging Clin N Am 2014;24:67-78
  20. Chalian M, Chhabra A. Top-10 tips for getting started with magnetic resonance neurography. Semin Musculoskelet Radiol 2019;23:347-360
  21. Muniz Neto FJ, Kihara Filho EN, Miranda FC, Rosemberg LA, Santos DCB, Taneja AK. Demystifying MR neurography of the lumbosacral plexus: from protocols to pathologies. Biomed Res Int 2018;2018:9608947
  22. Baumer P, Weiler M, Bendszus M, Pham M. Somatotopic fascicular organization of the human sciatic nerve demonstrated by MR neurography. Neurology 2015;84:1782-1787
  23. Saraf-Lavi E. Imaging of the brachial and sacral plexus. Appl Radiol 2014;43:5-10
  24. Neufeld EA, Shen PY, Nidecker AE, Runner G, Bateni C, Tse G, et al. MR imaging of the lumbosacral plexus: a review of techniques and pathologies. J Neuroimaging 2015;25:691-703
  25. Chappell KE, Robson MD, Stonebridge-Foster A, Glover A, Allsop JM, Williams AD, et al. Magic angle effects in MR neurography. AJNR Am J Neuroradiol 2004;25:431-440
  26. Lee H, Lee JW, Lee JH, Kang HS. Comparison of different 3.0 T magnetic resonance sequences for lumbosacral plexus and its branches: preliminary study. J Korean Soc Radiol 2013;68:49-55
  27. Chhabra A, Carrino J. Current MR neurography techniques and whole-body MR neurography. Semin Musculoskelet Radiol 2015;19:79-85
  28. Grayev A, Reeder S, Hanna A. Use of chemical shift encoded magnetic resonance imaging (CSE-MRI) for high resolution fat-suppressed imaging of the brachial and lumbosacral plexuses. Eur J Radiol 2016;85:1199-1207
  29. Zhang Z, Song L, Meng Q, Li Z, Pan B, Yang Z, et al. Morphological analysis in patients with sciatica: a magnetic resonance imaging study using three-dimensional high-resolution diffusion-weighted magnetic resonance neurography techniques. Spine (Phila Pa 1976) 2009;34:E245-E250
  30. Adachi Y, Sato N, Okamoto T, Sasaki M, Komaki H, Yamashita F, et al. Brachial and lumbar plexuses in chronic inflammatory demyelinating polyradiculoneuropathy: MRI assessment including apparent diffusion coefficient. Neuroradiology 2011;53:3-11
  31. Foti G, Lombardo F, Fighera A, Giaretta A, Catania M, Serra G, et al. Role of diffusion tensor imaging of sciatic nerve in symptomatic patients with inconclusive lumbar MRI. Eur J Radiol 2020;131:109249
  32. Menezes CM, de Andrade LM, Herrero CF, Defino HL, Ferreira Junior MA, Rodgers WB, et al. Diffusion-weighted magnetic resonance (DW-MR) neurography of the lumbar plexus in the preoperative planning of lateral access lumbar surgery. Eur Spine J 2015;24:817-826
  33. Chhabra A, Soldatos T, Subhawong TK, Machado AJ, Thawait SK, Wang KC, et al. The application of three-dimensional diffusion-weighted PSIF technique in peripheral nerve imaging of the distal extremities. J Magn Reson Imaging 2011;34:962-967
  34. Chavhan GB, Babyn PS, Jankharia BG, Cheng HL, Shroff MM. Steady-state MR imaging sequences: physics, classification, and clinical applications. Radiographics 2008;28:1147-1160
  35. Kasper JM, Wadhwa V, Scott KM, Rozen S, Xi Y, Chhabra A. SHINKEI--a novel 3D isotropic MR neurography technique: technical advantages over 3DIRTSE-based imaging. Eur Radiol 2015;25:1672-1677
  36. Wang J, Yarnykh VL, Yuan C. Enhanced image quality in black-blood MRI using the improved motion-sensitized driven-equilibrium (iMSDE) sequence. J Magn Reson Imaging 2010;31:1256-1263
  37. Hiwatashi A, Togao O, Yamashita K, Kikuchi K, Kamei R, Momosaka D, et al. Lumbar plexus in patients with chronic inflammatory demyelinating polyneuropathy: evaluation with 3D nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation enhancement imaging (3D SHINKEI). Eur J Radiol 2017;93:95-99
  38. Zhang Y, Kong X, Zhao Q, Liu X, Gu Y, Xu L. Enhanced MR neurography of the lumbosacral plexus with robust vascular suppression and improved delineation of its small branches. Eur J Radiol 2020;129:109128
  39. Cho Sims G, Boothe E, Joodi R, Chhabra A. 3D MR neurography of the lumbosacral plexus: obtaining optimal images for selective longitudinal nerve depiction. AJNR Am J Neuroradiol 2016;37:2158-2162
  40. Harrell AD, Johnson D, Samet J, Omar IM, Deshmukh S. With or without? A retrospective analysis of intravenous contrast utility in magnetic resonance neurography. Skeletal Radiol 2020;49:577-584
  41. Deshmukh S, Tegtmeyer K, Kovour M, Ahlawat S, Samet J. Diagnostic contribution of contrast-enhanced 3D MR imaging of peripheral nerve pathology. Skeletal Radiol 2021;50:2509-2518
  42. Wolf M, Baumer P, Pedro M, Dombert T, Staub F, Heiland S, et al. Sciatic nerve injury related to hip replacement surgery: imaging detection by MR neurography despite susceptibility artifacts. PLoS One 2014;9:e89154
  43. Ahlawat S, Stern SE, Belzberg AJ, Fritz J. High-resolution metal artifact reduction MR imaging of the lumbosacral plexus in patients with metallic implants. Skeletal Radiol 2017;46:897-908
  44. Chazen JL, Cornman-Homonoff J, Zhao Y, Sein M, Feuer N. MR neurography of the lumbosacral plexus for lower extremity radiculopathy: frequency of findings, characteristics of abnormal intraneural signal, and correlation with electromyography. AJNR Am J Neuroradiol 2018;39:2154-2160
  45. Laporte C, Albert JD, Duvauferrier R, Bertaud V, Gouillou M, Guillin R. MRI investigation of radiating pain in the lower limbs: value of an additional sequence dedicated to the lumbosacral plexus and pelvic girdle. AJR Am J Roentgenol 2014;203:1280-1285
  46. Petrasic JR, Chhabra A, Scott KM. Impact of MR neurography in patients with chronic cauda equina syndrome presenting as chronic pelvic pain and dysfunction. AJNR Am J Neuroradiol 2017;38:418-422
  47. Poh F, Xi Y, Rozen SM, Scott KM, Hlis R, Chhabra A. Role of MR neurography in groin and genital pain: ilioinguinal, iliohypogastric, and genitofemoral neuralgia. AJR Am J Roentgenol 2019;212:632-643
  48. Chhabra A, Belzberg AJ, Rosson GD, Thawait GK, Chalian M, Farahani SJ, et al. Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management. Eur Radiol 2016;26:1235-1244
  49. Dessouky R, Xi Y, Scott KM, Khaleel M, Gill K, Jones S, et al. Magnetic resonance neurography in chronic lumbosacral and pelvic pain: diagnostic and management impact-institutional audit. World Neurosurg 2018;114:e77-e113
  50. Lozeron P, Lacour MC, Vandendries C, Theaudin M, Cauquil C, Denier C, et al. Contribution of plexus MRI in the diagnosis of atypical chronic inflammatory demyelinating polyneuropathies. J Neurol Sci 2016;360:170-175
  51. Fargeot G, Viala K, Theaudin M, Labeyrie MA, Costa R, Leger JM, et al. Diagnostic usefulness of plexus magnetic resonance imaging in chronic inflammatory demyelinating polyradiculopathy without electrodiagnostic criteria of demyelination. Eur J Neurol 2019;26:631-638
  52. Kronlage M, Knop KC, Schwarz D, Godel T, Heiland S, Bendszus M, et al. Amyotrophic lateral sclerosis versus multifocal motor neuropathy: utility of MR neurography. Radiology 2019;292:149-156
  53. Ahlawat S, Belzberg AJ, Fayad LM. Utility of magnetic resonance imaging for predicting severity of sciatic nerve injury. J Comput Assist Tomogr 2018;42:580-587
  54. Garozzo D, Zollino G, Ferraresi S. In lumbosacral plexus injuries can we identify indicators that predict spontaneous recovery or the need for surgical treatment? Results from a clinical study on 72 patients. J Brachial Plex Peripher Nerve Inj 2014;9:1
  55. Hlis R, Poh F, Xi Y, Chhabra A. Diffusion tensor imaging of diabetic amyotrophy. Skeletal Radiol 2019;48:1705-1713
  56. Filosto M, Todeschini A, Cotelli M, Rinaldi F, Rota S, Padovani A, et al. Diffusion tensor imaging and tractography of the sciatic nerves in chronic inflammatory demyelinating polyradiculoneuropathy. J Peripher Nerv Syst 2013;18:S14-S15
  57. Bernabeu A, Lopez-Celada S, Alfaro A, Mas JJ, Sanchez-Gonzalez J. Is diffusion tensor imaging useful in the assessment of the sciatic nerve and its pathologies? Our clinical experience. Br J Radiol 2016;89:20150728
  58. Kronlage M, Baumer P, Pitarokoili K, Schwarz D, Schwehr V, Godel T, et al. Large coverage MR neurography in CIDP: diagnostic accuracy and electrophysiological correlation. J Neurol 2017;264:1434-1443
  59. Breckwoldt MO, Stock C, Xia A, Heckel A, Bendszus M, Pham M, et al. Diffusion tensor imaging adds diagnostic accuracy in magnetic resonance neurography. Invest Radiol 2015;50:498-504