Morphological analysis in patients with sciatica: a magnetic resonance imaging study using three-dimensional high-resolution diffusion-weighted magnetic resonance neurography techniques.
METHODS
A prospective observational study of patients with sciatica.


OBJECTIVE
We investigated the effectiveness of 3-dimensional high-spatial resolution diffusion-weighted MR neurography based on steady state free precession (3-dimensional diffusion-weighted steady-state free precession [DW-SSFP]) in the diagnosis of sciatica.


BACKGROUND
Patients with sciatica challenge a physician who desires a precise diagnosis for the etiology of the pain. Direct imaging of the sciatic nerve with high resolution and high contrast may contribute to accurate localization and help to find the causes of sciatica and provide reliable information to clinicians in treatment choice. Thus, we supposed that 3-dimensional DW-SSFP method have the ability to confirm the etiologies of sciatica.


METHODS
The 3-dimensional DW-SSFP sequence was performed on 137 patients with sciatica and 32 patients in control group. The postprocessing techniques were used to generate images of lumbosacral plexus and sciatic nerve, and the images acquired were assessed based on the presence or absence of nerve abnormality. The certainty of identifying the lumbosacral plexus and main branches from all cases was determined in each of the reconstruction planes for each case individually and assessed by using a 3-score scale.


RESULTS
All subjects were successfully performed. The sciatic nerve and its main branches were differentiated and a clear picture was obtained in all subjects. Compared with the control group, the presence of nerve root compression or increased T2 signal intensity changes can be observed in all patients. The mean score of certainty of identifying the sciatic nerve and main branches was 1.76 +/- 0.4, which indicate that the sciatic nerve and main branches can be identified with certainty.


CONCLUSIONS
The 3-dimensional DW-SSFP MRI with high spatial and sufficient contrast is an excellent technique to define the nature of sciatica and assists in prognostication and possibly in management.
Zhang
Zhongwei
Z
Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China.
Song
Laijing
L
Meng
Quanfei
Q
Li
Ziping
Z
Pan
Bitao
B
Yang
Zhihua
Z
Pei
Zhong
Z