Role of diffusion tensor imaging of sciatic nerve in symptomatic patients with inconclusive lumbar MRI

Foti, Giovanni; Lombardo, Fábio; Fighera, Alessandro; Giaretta, Alvise; Catania, Matteo; Serra, Gerardo; Carbognin, Giovanni

doi:10.1016/j.ejrad.2020.109249

Cited by 7 publications

(3 citation statements)

References 28 publications

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“…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%

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%

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

Kim¹,

Jung²

2022

J Korean Soc Radiol

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“…While advanced imaging techniques, such as diffusion tensor imaging (DTI), have been introduced for the visualization of the sciatic nerve [22], we analyze an important study cohort that did not rely on DTI or other advanced imaging techniques. Given the widespread prevalence of nerve injury, our study shows that routine clinical sequences can be used to diagnose extraspinal sciatica without expensive, specialized coils that may be inaccessible in resource-limited imaging centers.…”

Section: Discussionmentioning

confidence: 99%

Variant Sciatic Nerve Anatomy in Relation to the Piriformis Muscle on Magnetic Resonance Neurography: A Potential Etiology for Extraspinal Sciatica

Bharadwaj

Varenika

Carson³

et al. 2023

Tomography

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Objective: To assess the prevalence and clinical implications of variant sciatic nerve anatomy in relation to the piriformis muscle on magnetic resonance neurography (MRN), in patients with lumbosacral neuropathic symptoms. Materials and Methods: In this retrospective single-center study, 254 sciatic nerves, from 127 patients with clinical and imaging findings compatible with extra-spinal sciatica on MRN between 2003 and 2013, were evaluated for the presence and type of variant sciatic nerves, split sciatic nerve, abnormal T2-signal hyperintensity, asymmetric piriformis size and increased nerve caliber, and summarized using descriptive statistics. Two-tailed chi-square tests were performed to compare the anatomical variant type and clinical symptoms between imaging and clinical characteristics. Results: Sixty-four variant sciatic nerves were identified with an equal number of right and left variants. Bilateral variants were noted in 15 cases. Abnormal T2-signal hyperintensity was seen significantly more often in variant compared to conventional anatomy (40/64 vs. 82/190; p = 0.01). A sciatic nerve split was seen significantly more often in variant compared to conventional anatomy (56/64 vs. 20/190; p < 0.0001). Increased nerve caliber, abnormal T2-signal hyperintensity, and asymmetric piriformis size were significantly associated with the clinically symptomatic side compared to the asymptomatic side (98:2, 98:2, and 97:3, respectively; p < 0.0001 for all). Clinical symptoms were correlated with variant compared to conventional sciatic nerve anatomy (64% vs. 46%; p = 0.01). Conclusion: Variant sciatic nerve anatomy, in relation to the piriformis muscle, is frequently identified with MRN and is more likely to be associated with nerve signal changes and symptomatology.

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“…Diagnosis is made by clinical findings such as MRI but many anatomic variants may have gone undiagnosed in the past due to the lack of or limitations of imaging studies [10,11]. An advanced technique of MR neurography may also be useful in assisting the diagnosis of this condition.…”

Section: Introductionmentioning

confidence: 99%

Sacroiliac joint manipulation helps to improve pain pressure threshold in chronic piriformis syndrome: a 6-week randomized controlled trial US

Shahzadi¹,

Taj²,

Nawaz³

et al. 2023

T Rehabili. J.

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Background: Piriformis syndrome (PS) has negative impact on the daily activities of the patients and lead to disability. There is an anatomical association of piriformis muscle with sacroiliac joint (SIJ). So manual therapy including manipulation of SI joint may be the option for relieving the symptoms of PS Objective: To investigate the effectiveness of Sacroiliac joint manipulation in improving pain pressure threshold in patients with chronic piriformis syndrome. Materials and Methods: A randomized clinical trial (NCT04603703) was conducted at Max Rehab and Physical Therapy Centre G8-Markaz, Islamabad, Pakistan. A total of n=30 patients were randomly divided into Experimental group (n=15) and control group (n=15). Both groups received conventional physical therapy including therapeutic ultrasound, moist hot pack, piriformis muscle stretching, myofascial release of paraspinal muscles, gluteal strengthening, sciatic neurodynamics. The experimental group additionally received sacroiliac joint manipulation. The outcome measures were pain, straight leg raise (SLR), pain pressure threshold and piriformis muscle length. The total time frame of the treatment was 3 days per week for 6 weeks and pre and post intervention assessment was done. Result: The mean age of participants was 40.46 ±10.513 years. Pain, SLR, pain pressure threshold and piriformis length was significantly improved (p<0.001) in both the experimental and control group after 6th week intervention. Between group comparison there was no significant difference between the groups after 6-week intervention regarding the pain, SLR and piriformis muscle length, except pain pressure threshold which was significantly improved in experimental group as compared to control group (67.7±18.42 vs 52.51±15.26, p=0.020) . Conclusion: Addition of the sacroiliac joint thrust manipulation technique and conventional physical therapy alone were equally effective in decreasing pain intensity and normalizing length of Piriformis and Straight leg raise. But SIJ manipulation showed promising results on pain pressure threshold. Keywords: Articular, physical therapy modalities, piriformis muscle syndrome, pain threshold, range of motion, sacroiliac joint.

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Role of diffusion tensor imaging of sciatic nerve in symptomatic patients with inconclusive lumbar MRI

Cited by 7 publications

References 28 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

Variant Sciatic Nerve Anatomy in Relation to the Piriformis Muscle on Magnetic Resonance Neurography: A Potential Etiology for Extraspinal Sciatica

Sacroiliac joint manipulation helps to improve pain pressure threshold in chronic piriformis syndrome: a 6-week randomized controlled trial US

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