Is diffusion tensor imaging useful in the assessment of the sciatic nerve and its pathologies? Our clinical experience

Bernabéu, A; López-Celada, Susana; Alfaro, Arantxa; Mas, Jesús J; Sánchez‐González, Javier

doi:10.1259/bjr.20150728

Cited by 17 publications

(10 citation statements)

References 14 publications

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“…Recently, advanced MRI techniques such as diffusion tensor imaging (DTI) has been studied in the evaluation of sciatica. These studies have found a lower fractional anisotropy (FA) and higher apparent diffusion coefficient values in the affected nerves in comparison with the contralateral side [18,19].…”

Section: Imagingmentioning

confidence: 97%

Clinico-radiological review of peripheral entrapment neuropathies – Part 2 Lower limb

Manoharan

Sudhakaran

Goyal

et al. 2021

European Journal of Radiology

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This review discusses the relevant anatomy, etiopathogenesis, current notions in clinical and imaging features as well as management outline of lower limb entrapment neuropathies. Methods: The review is based on critical analysis of the current literature as well as our experience in dealing with entrapment neuropathies of the lower limb. Results: The complex anatomical network of nerves supplying the lower extremities are prone to entrapment by a heterogenous group of etiologies. This leads to diverse clinical manifestations making them difficult to diagnose with traditional methods such as clinical examination and electrodiagnostic studies. Moreover, some of these may mimic other common conditions such as disc pain or fibromyalgia leading to delay in diagnosis and increasing morbidity. Addition of imaging improves the diagnostic accuracy and also help in correct treatment of these entities. Magnetic resonance imaging is very useful for deeply situated nerves in pelvis and thigh while ultrasound is well validated for superficial entrapment neuropathies. Conclusion: The rapidly changing concepts in these conditions accompanied by the advances in imaging has made it essential for a clinical radiologist to be well-informed with the current best practices.

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Section: Imagingmentioning

confidence: 97%

Clinico-radiological review of peripheral entrapment neuropathies – Part 2 Lower limb

Manoharan

Sudhakaran

Goyal

et al. 2021

European Journal of Radiology

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“…Routine MRI has been widely used to study the normal anatomy and pathology of the sciatic nerve and the associated muscle oedema or denervation, especially on T2-weighted sequences [ 67 ]. DTI may implement conventional MRI examination, providing additional information regarding the myelinic structures [ 68 ]. DTI does not show significant differences in either FA or ADC values at any level between sciatic nerve in the dominant or non-dominant lower limb.…”

Section: Specific Applications In the Musculoskeletal Systemmentioning

confidence: 99%

“…Manoeuvres of flexion, adduction and internal rotation of the hip, and direct palpation of the piriformis, cause severe pain. CT and MRI may help to diagnose PS and to differentiate it from other possible causes of lower lumbar pain; however, imaging diagnosis remains challenging [ 68 ].…”

Section: Specific Applications In the Musculoskeletal Systemmentioning

confidence: 99%

Diffusion tensor imaging in the musculoskeletal and peripheral nerve systems: from experimental to clinical applications

et al. 2017

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Magnetic resonance imaging (MRI) is a well-established imaging modality which is used in all districts of the musculoskeletal and peripheral nerve systems. More recently, initial studies have applied multiparametric MRI to evaluate quantitatively different aspects of musculoskeletal and peripheral nerve diseases, thus providing not only images but also numbers and clinical data. Besides 1H and 31P magnetic resonance spectroscopy, diffusion-weighted imaging (DWI) and blood oxygenation level-dependent imaging, diffusion tensor imaging (DTI) is a relatively new MRI-based technique relying on principles of DWI, which has traditionally been used mainly for evaluating the central nervous system to track fibre course. In the musculoskeletal and peripheral nerve systems, DTI has been mostly used in experimental settings, with still few indications in clinical practice. In this review, we describe the potential use of DTI to evaluate different musculoskeletal and peripheral nerve conditions, emphasising the translational aspects of this technique from the experimental to the clinical setting.

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“…The diffusion-weighted data were transferred to a workstation for analysis and eddy current compensation was performed by affine registration to B0 image. Tractography was carried out using the PRIDE fiber-tracking tool (Philips Medical Systems) as described previously (Alfaro et al, 2015 ; Bernabeu et al, 2016 ) and was fulfilled based on the connection between two areas of regions of interest (ROIs), the ROIs were drawn manually based on the anatomical MRI and on published atlases (Wakana et al, 2004 ). The fibers were computed automatically by the software with the following parameters as stopping criteria: minimum fractional anisotropy value (FA) of 0.3, maximum fiber angle between fibers of 27° and minimum fiber length of 10 mm.…”

Section: Case Reportmentioning

confidence: 99%

When Playing Is a Problem: An Atypical Case of Alien Hand Syndrome in a Professional Pianist

Alfaro

Bernabéu²,

Badesa

et al. 2017

Front. Hum. Neurosci.

Self Cite

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Alien hand syndrome (AHS) is a neurological illness characterized by limb movements which are carried out without being aware of it. Many patients describe these movements as aggressive and some perceive a strong feeling of estrangement and go so far as to deny ownership. The sense of body ownership is the perception that parts of one’s body pertain to oneself, despite it is moving or not and if movement is intentional or unintentional. These anomalous self-experiences may arise in patients with focal brain lesions and provide unique opportunities to disclose the neural components underlying self-body perception. The feeling of foreignness described in AHS is often observed in post-central cortical lesions in the non-dominant hemisphere and is typical of the “posterior alien hand variant”. We used Diffusion-Tensor magnetic resonance imaging (DT-MRI) in an unusual case of posterior AHS of the dominant hand in a professional pianist with corticobasal syndrome (CBS). The patient showed uncontrolled levitation with the right arm while playing the piano and perceived as if her hand had a “mind of its own” which prevented her from playing. MRI-scans show asymmetric brain atrophy, mainly involving left post-central regions and SPECT-Tc99m-ECD patterns of hypometabolism over the left parietal-occipital cortices. DT-MRI revealed extensive damage which comprised left fronto-temporal cortex and extends into the ipsilateral parietal cortex causing a disruption of corpus callosum (CC) projections from the rostrum to the splenium. Our case illustrates that posterior AHS may occur in the dominant hemisphere due to widespread damage, which exceed parietal cortex. The parietal lobe has been recognized as a multimodal association region that gets input from several networks and organizes motor output. We suggest that the disturbance to this pathway could result in disruption of motor output and associate an abnormal motor control and anomalous self-body perception.

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Is diffusion tensor imaging useful in the assessment of the sciatic nerve and its pathologies? Our clinical experience

Cited by 17 publications

References 14 publications

Clinico-radiological review of peripheral entrapment neuropathies – Part 2 Lower limb

Clinico-radiological review of peripheral entrapment neuropathies – Part 2 Lower limb

Diffusion tensor imaging in the musculoskeletal and peripheral nerve systems: from experimental to clinical applications

When Playing Is a Problem: An Atypical Case of Alien Hand Syndrome in a Professional Pianist

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