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Identifying lumbosacral plexus nerve root abnormalities in patients with sciatica using 3T readout-segmented echo-planar diffusion weighted MR neurography
OBJECTIVES: To investigate the accuracy of Diffusion Weighted Imaging (DWI) using the Readout Segmentation of Long Variable Echo-trains (RESOLVE) sequence in detecting lumbosacral nerve abnormalities. METHODS: Following institutional ethics committee approval, patients with sciatica-type lower limb...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058120/ https://www.ncbi.nlm.nih.gov/pubmed/33877460 http://dx.doi.org/10.1186/s13244-021-00992-w |
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author | Abdulaal, Osamah M. McGee, Allison Rainford, Louise O’Driscoll, Dearbhail Galligan, Marie Reid, Valerie MacMahon, Peter J. |
author_facet | Abdulaal, Osamah M. McGee, Allison Rainford, Louise O’Driscoll, Dearbhail Galligan, Marie Reid, Valerie MacMahon, Peter J. |
author_sort | Abdulaal, Osamah M. |
collection | PubMed |
description | OBJECTIVES: To investigate the accuracy of Diffusion Weighted Imaging (DWI) using the Readout Segmentation of Long Variable Echo-trains (RESOLVE) sequence in detecting lumbosacral nerve abnormalities. METHODS: Following institutional ethics committee approval, patients with sciatica-type lower limb radicular symptoms (n = 110) were recruited and prospectively scanned using 3T MRI. Additional participants (n = 17) who underwent neurophysiological testing (EMG/NCV), were also prospectively studied. In addition to routine lumbar spine MRI, a DWI-RESOLVE sequence of the lumbosacral plexus was performed. Two radiologists, blinded to the side of patient symptoms, independently evaluated the MR images. The size and signal intensity changes of the nerves were evaluated using ordinal 4-point Likert-scales. Signal-to-noise ratio (SNR), apparent diffusion coefficient (ADC) and size were measured for affected and normal nerves. Inter-observer agreement was determined with kappa statistics; κ. RESULTS: In patients who did not undergo EMG/NCV testing (n = 110), the DWI-RESOLVE sequence detected lumbosacral nerve abnormalities that correlated with symptoms in 36.3% (40/110). This is a similar percentage to patients who underwent EMG/NCV testing, which was positive and correlated with symptoms in 41.2% (7/17). Inter-observer agreement for evaluation of lumbosacral nerve abnormalities was excellent and ranged from 0.87 to 0.94. SNR and nerve size measurements demonstrated statistically significant differences for the L5 and S1 nerves (p value < 0.05) for patients who did not undergo EMG/NCV testing. CONCLUSION: The DWI-RESOLVE sequence is a promising new method that may permit accurate detection and localization of lumbar nerve abnormalities in patients with sciatica. |
format | Online Article Text |
id | pubmed-8058120 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-80581202021-05-05 Identifying lumbosacral plexus nerve root abnormalities in patients with sciatica using 3T readout-segmented echo-planar diffusion weighted MR neurography Abdulaal, Osamah M. McGee, Allison Rainford, Louise O’Driscoll, Dearbhail Galligan, Marie Reid, Valerie MacMahon, Peter J. Insights Imaging Original Article OBJECTIVES: To investigate the accuracy of Diffusion Weighted Imaging (DWI) using the Readout Segmentation of Long Variable Echo-trains (RESOLVE) sequence in detecting lumbosacral nerve abnormalities. METHODS: Following institutional ethics committee approval, patients with sciatica-type lower limb radicular symptoms (n = 110) were recruited and prospectively scanned using 3T MRI. Additional participants (n = 17) who underwent neurophysiological testing (EMG/NCV), were also prospectively studied. In addition to routine lumbar spine MRI, a DWI-RESOLVE sequence of the lumbosacral plexus was performed. Two radiologists, blinded to the side of patient symptoms, independently evaluated the MR images. The size and signal intensity changes of the nerves were evaluated using ordinal 4-point Likert-scales. Signal-to-noise ratio (SNR), apparent diffusion coefficient (ADC) and size were measured for affected and normal nerves. Inter-observer agreement was determined with kappa statistics; κ. RESULTS: In patients who did not undergo EMG/NCV testing (n = 110), the DWI-RESOLVE sequence detected lumbosacral nerve abnormalities that correlated with symptoms in 36.3% (40/110). This is a similar percentage to patients who underwent EMG/NCV testing, which was positive and correlated with symptoms in 41.2% (7/17). Inter-observer agreement for evaluation of lumbosacral nerve abnormalities was excellent and ranged from 0.87 to 0.94. SNR and nerve size measurements demonstrated statistically significant differences for the L5 and S1 nerves (p value < 0.05) for patients who did not undergo EMG/NCV testing. CONCLUSION: The DWI-RESOLVE sequence is a promising new method that may permit accurate detection and localization of lumbar nerve abnormalities in patients with sciatica. Springer International Publishing 2021-04-20 /pmc/articles/PMC8058120/ /pubmed/33877460 http://dx.doi.org/10.1186/s13244-021-00992-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Abdulaal, Osamah M. McGee, Allison Rainford, Louise O’Driscoll, Dearbhail Galligan, Marie Reid, Valerie MacMahon, Peter J. Identifying lumbosacral plexus nerve root abnormalities in patients with sciatica using 3T readout-segmented echo-planar diffusion weighted MR neurography |
title | Identifying lumbosacral plexus nerve root abnormalities in patients with sciatica using 3T readout-segmented echo-planar diffusion weighted MR neurography |
title_full | Identifying lumbosacral plexus nerve root abnormalities in patients with sciatica using 3T readout-segmented echo-planar diffusion weighted MR neurography |
title_fullStr | Identifying lumbosacral plexus nerve root abnormalities in patients with sciatica using 3T readout-segmented echo-planar diffusion weighted MR neurography |
title_full_unstemmed | Identifying lumbosacral plexus nerve root abnormalities in patients with sciatica using 3T readout-segmented echo-planar diffusion weighted MR neurography |
title_short | Identifying lumbosacral plexus nerve root abnormalities in patients with sciatica using 3T readout-segmented echo-planar diffusion weighted MR neurography |
title_sort | identifying lumbosacral plexus nerve root abnormalities in patients with sciatica using 3t readout-segmented echo-planar diffusion weighted mr neurography |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058120/ https://www.ncbi.nlm.nih.gov/pubmed/33877460 http://dx.doi.org/10.1186/s13244-021-00992-w |
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