Diffusion tensor imaging with fiber tracking provides a valuable quantitative and clinical evaluation for compressed lumbosacral nerve roots: a systematic review and meta-analysis

Liang, Weishi; Han, Bo; Hai, Yong; Yin, Peng; Chen, Yuxiang; Zou, Congying

doi:10.1007/s00586-020-06556-8

Cited by 7 publications

(7 citation statements)

References 31 publications

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“…Diffusion-weighted imaging (DWI) effectively improves nerve conspicuity by suppressing background tissues and vessels ( 29 ). In addition, DWI with DTI also provides quantitative values such as apparent diffusion coefficient (ADC) and fractional anisotropy (FA) ( 7 30 ). For LSP, axial DTI is obtained with b-value of 600–900, and 15–20 directions ( 20 31 ).…”

Section: Resultsmentioning

confidence: 99%

“…DTI can provide additional information. FA reduction and ADC increase were the indicators of compressive neuropathy ( 7 18 ) and diabetic amyotrophy ( 55 ). In a recently published systematic review, the authors found 10 papers regarding DTI on lumbosacral nerve roots ( 7 ).…”

Section: Resultsmentioning

confidence: 99%

“…FA reduction and ADC increase were the indicators of compressive neuropathy ( 7 18 ) and diabetic amyotrophy ( 55 ). In a recently published systematic review, the authors found 10 papers regarding DTI on lumbosacral nerve roots ( 7 ). However, the selected papers in that review were DTI studies on lumbar spines mainly focused on spinal nerve roots and spinal nerves.…”

Section: Resultsmentioning

confidence: 99%

“…Among the 55 papers, there were 30 original articles, 12 review articles, 9 technical notes, and 4 case series. One review article was a systematic review on diffusion tensor imaging (DTI) for compressed lumbosacral nerve roots ( 7 ).…”

Section: Methodsmentioning

confidence: 99%

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Role of MR Neurography for Evaluation of the Lumbosacral Plexus: A Scoping Review

Kim¹,

Jung²

2022

J Korean Soc Radiol

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Role of MR Neurography for Evaluation of the Lumbosacral Plexus: A Scoping Review

Kim¹,

Jung²

2022

J Korean Soc Radiol

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“…Sciatica is caused by the compression of the sciatic nerve with a herniated intervertebral disc. Additionally, epidemiological investigations have reported that LDH is the most common cause of nerve root compression in the lumbosacral region [ 3 ]. The main signs and symptoms of LDH include rhizomatic pain, hyperalgesia and incompetence in the circulation of a nerve root in one or more lumbosacral regions [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Nerve abnormalities in lumbar disc herniation: A systematic review and meta-analysis of diffusion tensor imaging

et al. 2022

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Purpose The purpose of this study was to examine the values of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in diffusion tensor imaging (DTI) for diagnosing patients with nerve impairment due to lumbar disc herniation (LDH). Methods A literature search of databases (PubMed, Web of Science, Cochrane Library and Embase) was systematically performed to identify articles published before September 2021 that were relevant to this study. FA and ADC estimates of compressed nerve roots due to LDH and healthy controls in the same segment were compared, with either fixed or random effects models selected according to I2 heterogeneity. Additionally, subgroup analysis, sensitivity analysis, potential publication bias analysis and meta-regression analysis were also performed. Results A total of 369 patients with LDH from 11 publications were included in this meta-analysis. The results showed significantly lower FA values (Weighted Mean Difference (WMD): -0.08, 95% confidence interval (CI): -0.09 to -0.07, P ≤ 0.001, I2 = 87.6%) and significantly higher ADC values (WMD: 0.25, 95% CI: 0.20 to 0.30, P ≤ 0.001, I2 = 71.4%) of the nerve on the compressed side due to LDH compared to the healthy side. Subgroup analysis indicated that different countries and magnetic field strengths may be associated with higher heterogeneity. Furthermore, meta-regression analysis further revealed that segment and field strength did not have a significant effect on the results, regardless of the FA or ADC values. Contrastingly, in FA, the year of publication, country, b value and directions showed an effect on the results. Conclusions This meta-analysis showed a significant decrease in FA and a significant increase in ADC in patients with nerve damage due to LDH. The results favourably support the presence of nerve impairment in patients with LDH.

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Clinical Value and Reliability of Quantitative Assessments of Lumbosacral Nerve Root Using Diffusion Tensor and Diffusion Weighted MR Imaging: A Systematic Review

Pesesse,

Vanderthommen,

Durieux

et al. 2024

Magnetic Resonance Imaging

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BackgroundLumbosacral radicular pain diagnosis remains challenging. Diffusion tensor imaging (DTI) and diffusion weighted imaging (DWI) have potential to quantitatively evaluate symptomatic nerve root, which may facilitate diagnosis.PurposeTo determine the ability of DTI and DWI metrics, namely fractional anisotropy (FA) and apparent diffusion coefficient (ADC), to discriminate between healthy and symptomatic lumbosacral nerve roots, to evaluate the association between FA and ADC values and patient symptoms, and to determine FA and ADC reliability.Study TypeSystematic review.SubjectsEight hundred twelve patients with radicular pain with or without radiculopathy caused by musculoskeletal‐related compression or inflammation of a single, unilateral lumbosacral nerve root and 244 healthy controls from 29 studies.Field Strength/SequenceDiffusion weighted echo planar imaging sequence at 1.5 T or 3 T.AssessmentAn extensive systematic review of the literature was conducted in Embase, Scopus, and Medline databases. FA and ADC values in symptomatic and contralateral lumbosacral nerve roots were extracted and summarized, together with intra‐ and inter‐rater agreements. Where available, associations between DWI or DTI parameters and patient symptoms or symptom duration were extracted.Statistical TestsThe main results of the included studies are summarized. No additional statistical analyses were performed.ResultsThe DTI studies systematically found significant differences in FA values between the symptomatic and contralateral lumbosacral nerve root of patients suffering from radicular pain with or without radiculopathy. In contrast, identification of the symptomatic nerve root with ADC values was inconsistent for both DTI and DWI studies. FA values were moderately to strongly correlated with several symptoms (eg, disability, nerve dysfunction, and symptom duration). The inter‐ and intra‐rater reliability of DTI parameters were moderate to excellent. The methodological quality of included studies was very heterogeneous.Data ConclusionThis systematic review showed that DTI was a reliable and discriminative imaging technique for the assessment of symptomatic lumbosacral nerve root, which more consistently identified the symptomatic nerve root than DWI. Further studies of high quality are needed to confirm these results.Evidence LevelN/ATechnical EfficacyStage 2

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Diffusion tensor imaging with fiber tracking provides a valuable quantitative and clinical evaluation for compressed lumbosacral nerve roots: a systematic review and meta-analysis

Cited by 7 publications

References 31 publications

Role of MR Neurography for Evaluation of the Lumbosacral Plexus: A Scoping Review

Role of MR Neurography for Evaluation of the Lumbosacral Plexus: A Scoping Review

Nerve abnormalities in lumbar disc herniation: A systematic review and meta-analysis of diffusion tensor imaging

Clinical Value and Reliability of Quantitative Assessments of Lumbosacral Nerve Root Using Diffusion Tensor and Diffusion Weighted MR Imaging: A Systematic Review

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