Información del artículo
Resumen
La neurografía por resonancia magnética (RM) hace referencia a un conjunto de técnicas con capacidad para valorar óptimamente la estructura de los nervios periféricos y de los plexos nerviosos. Las nuevas secuencias neurográficas 2D y 3D, en particular en equipos de 3 Tesla, consiguen un contraste excelente entre el nervio y las estructuras perineurales. La neurografía por RM permite distinguir el patrón fascicular normal del nervio y diferenciarlo de las anomalías que lo afectan, como inflamaciones, traumas y tumores. En este artículo se describe la estructura del nervio ciático, sus características en la neurografía por RM y las dolencias que lo afectan con mayor frecuencia.
Palabras clave:
Nervio ciático
Neuropatía ciática
Neurografía
Imagen por resonancia magnética
Abstract
Magnetic resonance (MR) neurography refers to a set of techniques that enable the structure of the peripheral nerves and nerve plexuses to be evaluated optimally. New two-dimensional and three-dimensional neurographic sequences, in particular in 3T scanners, achieve excellent contrast between the nerve and perineural structures. MR neurography makes it possible to distinguish between the normal fascicular pattern of the nerve and anomalies like inflammation, trauma, and tumor that can affect nerves. In this article, we describe the structure of the sciatic nerve, its characteristics on MR neurography, and the most common diseases that affect it.
Keywords:
Sciatic nerve
Sciatic neuropathy
Neurography
Magnetic resonance imaging
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Bibliografía
[1]
C.K. Jablecki, M.T. Andary, Y.T. So, D.E. Wilkins, F.H. Williams.
Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome: AAEM Quality Assurance Committee.
Muscle Nerve, 16 (1993), pp. 1392-1414
[2]
A.L. Dellon.
Management of peripheral nerve problems in the upper and lower extremity using quantitative sensory testing.
Hand Clin, 15 (1999), pp. 697-715
[3]
A. Chhabra, P.P. Lee, C. Bizzell, T. Soldatos.
3 Tesla MR neurography-technique, interpretation, and pitfalls.
Skeletal Radiol, 40 (2011), pp. 1249-1260
[4]
F. Howe, A.G. Filler, B.A. Bell, J.R. Griffiths.
Magnetic resonance neurography.
Magn Reson Med, 28 (1992), pp. 328-338
[5]
T.K. Subhawong, K.C. Wang, S.K. Thawait, E.H. Williams, S.S. Hashemi, MachadoA.J., et al.
High resolution imaging of tunnels by magnetic resonance neurography.
Skeletal Radiol, 41 (2012), pp. 15-31
[6]
C.M. Gerdes, R. Kijowski, S.B. Reeder.
IDEAL imaging of the musculoskeletal system: robust water–fat separation for uniform fat suppression, marrow evaluation, and cartilage imaging.
AJR Am J Roentgenol, 189 (2007), pp. W284-W291
[7]
H.T. Benzon, J.A. Katz, H.A. Benzon, M.S. Iqbal.
Piriformis syndrome: anatomic considerations, a new injection technique, and a review of the literature.
Anesthesiology, 98 (2003), pp. 1442-1448
[8]
J.L. Fleckenstein, J.V Crues III, C.D. Reimers.
Muscle imaging in health and disease.
Springer, (1996),
[9]
W.M. Byun, H.W. Jang, S.W. Kim.
Three-dimensional magnetic resonance rendering imaging of lumbosacralradiculography in the diagnosis of symptomatic extraforaminal disc herniation with or without foraminal extension.
Spine (Phila Pa 1976), 3 (2012), pp. 840-844
[10]
W.T. Dixon.
Simple proton spectroscopic imaging.
Radiology, 153 (1984), pp. 189-194
[11]
S. Fuller, S. Reeder, A. Shimakawa, H. Yu, J. Johnson, C. Beaulieu, et al.
Iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) fast spin-echo imaging of the ankle: initial clinical experience.
AJR Am J Roentgenol, 187 (2006), pp. 1442-1447
[12]
D.N. Costa, I. Pedrosa, C. McKenzie, S.B. Reeder, N.M. Rofsky.
Body MRI using IDEAL.
AJR Am J Roentgenol, 190 (2008), pp. 1076-1084
[13]
M.I. Vargas, M. Viallon, D. Nguyen, J.Y. Beaulieu, J. Delavelle, M. Becker.
New approaches in imaging of the brachial plexus.
Eur J Radiol, 74 (2010), pp. 403-410
[14]
Z. Zhang, L. Song, Q. Meng, Z. Li, B. Pan, Z. Yang, et al.
Morphological analysis in patients with sciatica: a magnetic resonance imaging study using three-dimensional high-resolution diffusion-weighted magnetic resonance neurography techniques.
Spine (Phila Pa 1976), 34 (2009), pp. E245-E250
[15]
J.A. McNab, K.L. Miller.
Sensitivity of diffusion weighted steady state free precession to anisotropic diffusion.
Magn Reson Med, 60 (2008), pp. 405-413
[16]
A. Filler.
Magnetic resonance neurography and diffusion tensor imaging: origins, history, and clinical impact of the first 50,000 cases with an assessment of efficacy and utility in a prospective 5000-patient study group.
Neurosurgery, 65 (2009), pp. 29-43
[17]
A. Chhabra, G. Andreisek, T. Soldatos, K.C. Wang, A.J. Flammang, A.J. Belzberg, et al.
MR neurography: past, present, and future.
AJR Am J Roentgenol, 197 (2011), pp. 583-591
[18]
S. Kim, J.Y. Choi, Y.M. Huh, H.T. Song, S.A. Lee, S.M. Kim, et al.
Role of magnetic resonance imaging in entrapment and compressive neuropathy: what, where, and how to see the peripherals nerves on the musculoskeletal magnetic resonance image: part I. Overview and lower extremity.
Eur Radiol, 17 (2007), pp. 139-149
[19]
S. Kim, J.Y. Choi, Y.M. Huh, H.T. Song, S.A. Lee, S.M. Kim, et al.
Role of magnetic resonance imaging in entrapment and compressive neuropathy: what, where, and how to see the peripherals nerves on the musculoskeletal magnetic resonance image: part II. Upper extremity.
Eur Radiol, 17 (2007), pp. 509-522
[20]
A. Chhabra, E.H. Williams, K.C. Wang, A.L. Dellon, J.A. Carrino.
MR neurography of neuromas related to nerve injury and entrapment with surgical correlation.
AJNR Am J Neuroradiol, 31 (2010), pp. 1363-1368
[21]
S.K. Thawait, K. Wang, T.K. Subhawong, E.H. Williams, S.S. Hashemi, A.J. Machado, et al.
Peripheral nerve surgery: the role of high-resolution MR neurography.
AJNR Am J Neuroradiol, 33 (2012), pp. 203-210
[22]
H. Seddon.
Three types of nerve injury.
Brain, 66 (1943), pp. 237-288
[23]
P.R. Mazal, H. Millesi.
Neurolysis: is it beneficial or harmful.
Acta Neurochir Suppl, 92 (2005), pp. 3-6
[24]
D.R. Robinson.
Pyriformis syndrome in relation to sciatic pain.
Am J Surg, 73 (1947), pp. 355-358
[25]
A.M. Lewis, R. Layzer, J.W. Engstrom, N.M. Barbaro, C.T. Chin.
Magnetic resonance neurography in extraspinal sciatica.
Arch Neurol, 63 (2006), pp. 1469-1472
[26]
J.D. Stewart.
The piriformis syndrome is overdiagnosed.
Muscle Nerve, 28 (2003), pp. 644-646
[27]
L. Serrano, J. Bencardino, J. Beltrán.
Neuropatías compresivas.
Musculoesquelético. Colección Avances en Diagnóstico por Imágenes. Colegio Interamericano de Radiología,
[28]
C.N. Petchprapa, Z.S. Rosenberg, L.M. Sconfienza, C.F. Cavalcanti, R.L. Vieira.
MR Imaging of entrapment neuropathies of the lower extremity. Part 1. The pelvis and hip.
Radiographics, 30 (2010), pp. 983-1000
[29]
W.H. Dornette.
Compression neuropathies: medical aspects and legal implications.
Int Anesthesiol Clin, 24 (1986), pp. 201-209
[30]
M.A. Warner, D.O. Warner, C.M. Harper, D.R. Schroeder, P.M. Maxson.
Lower extremity neuropathies associated with lithotomy positions.
Anesthesiology, 93 (2000), pp. 938-942
[31]
M.A. Warner, J.T. Martin, D.R. Schroeder, K.P. Offord, C.G. Chute.
Lower-extremity motor neuropathy associated with surgery performed on patients in a lithotomy position.
Anesthesiology, 81 (1994), pp. 6-12
[32]
O.A. El-Rubaidi, A. Horcajadas-Almansa, D. Rodríguez-Rubio, J.M. Galicia-Bulnes.
Compresión del nervio ciático como complicación de la posición sentada.
Neurocirugía (Astur), 14 (2003), pp. 426-430
[33]
D.H. Kim, J.A. Murovic, R.L. Tiel, G. Moes, D.G. Kline.
A series of 397 peripheral neural sheath tumors: 30-year experience at Louisiana State University Health Sciences Center.
J Neurosurg, 102 (2005), pp. 246-255
[34]
C. Blanchard, P. Dam-Hieu, F. Zagnoli, S. Bellard.
Chronic sciatic pain caused by sciatic nerve schwannoma.
Rev Med Interne, 29 (2008), pp. 748-750
[35]
A. Coulon, S. Milin, E. Laban, C. Debiais, C. Jamet, J.M. Goujon.
Pathologic characteristics of the most frequent peripheral nerve tumors.
Neurochirurgie, 55 (2009), pp. 454-458
[36]
W.H. Jee, S.N. Oh, T. Macaulay, K.N. Ryu, J.S. Suh, J.H. Lee, et al.
Extraaxial neurofibromas versus neurilemmomas: discrimination with MRI.
AJR Am J Roentgenol, 183 (2004), pp. 629-633
[37]
M.D. Murphey, W.S. Smith, S.E. Smith, M.J. Kransdorf, T.H. Temple.
From the archives of the AFIP. Imaging of musculoskeletal neurogenic tumors: radiologic-pathologic correlation.
Radiographics, 19 (1999), pp. 1253-1280
[38]
K. Woertler.
Tumors and tumor-like lesions of peripheral nerves.
Semin Musculoskelet Radiol, 14 (2010), pp. 547-558
[39]
M.N. Hébert-Blouin, K.K. Amrami, B.W. Scheithauer, R.J. Spinner.
Multinodular/plexiform (multifascicular) schwannomas of major peripheral nerves: an underrecognized part of the spectrum of schwannomas.
J Neurosurg, 112 (2010), pp. 372-382
[40]
Imaging of soft tissue tumors, 2nd ed., pp. 329-380
[41]
G. Gupta, A. Mammis, A. Maniker.
Malignant peripheral nerve sheath tumors.
Neurosurg Clin N Am, 19 (2008), pp. 533-543
[42]
L. Rodero, A. Canga, J. Figols, J. Berciano, O. Combarros.
Buttock mass and malignant sciatic nerve tumor.
Neurología, 19 (2004), pp. 27-31
[43]
E.M. Marom, C.A. Helms.
Fibrolipomatous hamartoma: pathognomonic on MR Imaging.
Skeletal Radiol, 28 (1999), pp. 260-264
[44]
B.Z. Wong, K.K. Amrami, D.E. Wenger, P.J. Dyck, B.W. Scheithauer, R.J. Spiner.
Lipomatosis of the sciatic nerve; typical and atypical MRI features.
Skeletal Radiol, 35 (2006), pp. 180-184
[45]
D.A. Krendel, R.L. Stahl, W.C. Chan.
Lymphomatous polyneuropathy: biopsy of clinically involved nerve and successful treatment.
Arch Neurol, 48 (1991), pp. 330-332
[46]
S. Mathis, L. Magy, L. Diallo, S. Boukhris, J.M. Vallat.
Amyloid neuropathy mimicking chronic inflammatory demyelinating polyneuropathy.
Muscle Nerve, 45 (2012), pp. 26-31
[47]
M.G. Hochman, J.L. Zilberfarb.
Nerves in a pinch: imaging of nerve compression syndromes.
Radiol Clin North Am, 42 (2004), pp. 221-245
[48]
H.C. Chiao, K.E. Marks, T.W. Bauer, W. Pflanze.
Intraneurallipoma of the sciatic nerve.
Clin Orthop Relat Res, 221 (1987), pp. 267-271
[49]
D.H. Kim, J.A. Murovic, R.L. Tiel, G. Moes, D.G. Kline.
A series of 146 peripheral non-neural sheath nerve tumors: 30-year experience at Louisiana State University Health Sciences Center.
J Neurosurg, 102 (2005), pp. 256-266
[50]
A. Mallouhi, W. Marik, D. Prayer, F. Kainberger, G. Bodner, G. Kasprian.
3T MR tomography of the brachial plexus: Structural and microstructural evaluation.
Eur J Radiol, 13 (2011), pp. 1-15
