Evaluation of the sacral nerve plexus in pelvic endometriosis by three-dimensional MR neurography

Xiaoling Zhang, Zhang X, Meizhi Li, Li M, Jian Guan, Guan J, Huanjun Wang, Wang H, Shurong Li, Li S, Guo Y, Yan Guo, Mingjuan Liu, Liu M
Journal of magnetic resonance imaging : JMRI · 2016 · vol. 45(4) , pp. 1225–1231 · doi:10.1002/jmri.25435 · PMID:27666420 · W2524452530
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Three-dimensional MR neurography successfully visualized the sacral plexus and identified nerve compression and adhesion due to endometriosis in 17 of 20 patients.

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Abstract

PURPOSE: To investigate the feasibility of three-dimensional MR neurography (3D MRN) for the sacral plexus using sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) sequences, and to demonstrate structural abnormalities in the pelvic nerve of women with pelvic endometriosis. MATERIALS AND METHODS: Twenty patients with pelvic endometriosis and 20 healthy controls were examined by contrast-enhanced 3D short time inversion recovery T2-weighted imaging (CE 3D STIR T2WI) SPACE sequences on 3 Tesla MRI. Image quality and diagnostic confidence of the sequences in identifying abnormalities of the sacral plexus were analyzed and compared with conventional three-plane images of 2D turbo-spin echo T2-weighted images (2D TSE T2WI). The changes in the sacral plexus caused by endometrial lesions were evaluated. RESULTS: The sacral plexus was clearly revealed in both healthy controls and patients with endometriosis on 3D STIR SPACE images. A good agreement was reached in the evaluation of both imaging quality (Kappa value [κ] = 0.73-1.00) and diagnostic confidence (κ = 0.66-0.81) when compared between the two independent readers. Abnormalities caused by endometriosis were identified in 17 patients, unilaterally in 10 patients, and bilaterally in 7 patients. Nerve fiber abnormalities of lumbar 5 (L5) were detected in 11 patients, of sacral 1 (S1) in 14 patients and of sacral 2 (S2) in 9 patients. CONCLUSION: CE 3D STIR SPACE sequences demonstrate its significant capacity to investigate and map the sacral plexus, and reveal the compression and adhesion of the sacral plexus nerve as a result of ectopic lesions. LEVEL OF EVIDENCE: 3 J. Magn. Reson. Imaging 2017;45:1225-1231.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Imaging, Three-Dimensional Lumbosacral Plexus Magnetic Resonance Imaging Adult Adult Endometriosis Endometriosis Feasibility Studies Feasibility Studies Female Female Humans Humans Image Interpretation, Computer-Assisted Image Interpretation, Computer-Assisted Image Interpretation, Computer-Assisted Imaging, Three-Dimensional Imaging, Three-Dimensional Lumbosacral Plexus

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (38)

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