Sciatic neuropathy: findings on magnetic resonance neurography

Injuries of the sciatic nerve are common causes of pain and limitation in the lower limbs. Due to its particular anatomy and its long course, the sciatic nerve is often involved in diseases of the pelvis or leg. In recent years, magnetic resonance neurography has become established as an important tool for the study of peripheral nerves and can be widely applied to the study of the sciatic nerve. Therefore, detailed knowledge of its anatomy and of the most prevalent diseases affecting it is essential to maximizing the accuracy of diagnostic imaging.

Keywords:
Sciatic nerve; Magnetic resonance imaging; Neuroimaging/methods; Nervous system diseases/diagnosis; Sciatic neuropathy/diagnosis

Authorship

Paulo Moraes Agnollitto Mailing address: Dr. Paulo Moraes Agnollitto. Divisão de Radiologia – FMRP-USP. Avenida Bandeirantes, 3900, Monte Alegre. Ribeirão Preto, SP, Brazil, 14048-900. E-mail: agno53@gmail.com

MD, Attending Physician in the Division of Radiology of the Department of Clinical Medicine at Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, BrazilUniversity of São PauloBrazilRibeirão Preto, SP, BrazilMD, Attending Physician in the Division of Radiology of the Department of Clinical Medicine at Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil

Marcio Wen King Chu

MD, Radiologist at the Clínica Radiológica WK Diagnose, Taubaté, SP, BrazilClínica Radiológica WK DiagnoseBrazilTaubaté, SP, BrazilMD, Radiologist at the Clínica Radiológica WK Diagnose, Taubaté, SP, Brazil

Marcelo Novelino Simão

PhD, Attending Physician in the Division of Radiology of the Department of Clinical Medicine at Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, BrazilUniversity of São PauloBrazilRibeirão Preto, SP, BrazilPhD, Attending Physician in the Division of Radiology of the Department of Clinical Medicine at Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil

Marcello Henrique Nogueira-Barbosa

Tenured Associate Professor in the Division of Radiology of the Department of Clinical Medicine at Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, BrazilUniversity of São PauloBrazilRibeirão Preto, SP, BrazilTenured Associate Professor in the Division of Radiology of the Department of Clinical Medicine at Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil

Mailing address: Dr. Paulo Moraes Agnollitto. Divisão de Radiologia – FMRP-USP. Avenida Bandeirantes, 3900, Monte Alegre. Ribeirão Preto, SP, Brazil, 14048-900. E-mail: agno53@gmail.com

SCIMAGO INSTITUTIONS RANKINGS

Figures

Figures (14)

Thumbnail

Figure 1
Coronal T1-weighted MRI scan showing the fascicular pattern (long arrow) and perineural fat (short arrows) around the proximal segment of the sciatic nerve.

Thumbnail

Figure 2
48-year-old male patient with schwannomatosis. A: Volumetric maximum intensity projection reconstruction of a coronal T2-weighted slice with fat saturation showing schwannomas in both sciatic nerves (arrows). B: Sagittal T2-weighted slice showing root schwannomas (arrows) within the spinal canal.

Thumbnail

Figure 3
30-year-old male patient with neurofibromatosis type 1. A: Coronal T2-weighted slice with fat saturation, showing plexiform neurofibromas in both sciatic nerves (arrows). B: Volumetric maximum intensity projection coronal T2-weighted slice with fat saturation, showing neurofibromas at the roots of the lumbosacral plexus (arrows).

Thumbnail

Figure 4
68-year-old female patient with increased volume of the right gluteal region and pain in the ipsilateral leg. A: Axial T2-weighted slice showing lipomatosis of the somatic nerve (solid arrow) accompanied by adipose infiltration into the ipsilateral pelvic girdle muscles (dashed arrows). B: Coronal T2-weighted slice of the pelvis, showing increased volume and adipose infiltration into the pelvic girdle muscles (arrows).

Thumbnail

Figure 5
32-year-old male patient with a history of neurofibromatosis, presenting with pain in the left leg and enlargement of the left gluteal region. Contrast-enhanced axial T1-weighted slice showing an expansile dumbbell-shaped formation (arrows) on the sciatic nerve in the region of the sciatic notch, consistent with malignant peripheral nerve sheath tumor, as was confirmed by histopathology.

Thumbnail

Figure 6
66-year-old male patient with rectal adenocarcinoma. Coronal T2-weighted slice showing an expansile lesion in the pelvic region, consistent with rectal adenocarcinoma, extending to the left sciatic notch (dashed arrows) and involving the right ipsilateral sciatic nerve (solid arrow).

Thumbnail

Figure 7
35-year-old male patient with a palpable mass in the left thigh. Axial T1-weighted slice showing a liposarcoma (dashed arrow) in the posterior compartment of the left thigh, compressing and displacing the ipsilateral sciatic nerve (solid arrow).

Thumbnail

Figure 8
A: Volumetric maximum intensity projection reconstruction of a coronal T2-weighted slice with fat saturation, showing diffuse thickening of the roots of the lumbosacral plexus (arrows). B: Axial T2-weighted slice with fat saturation, showing a similar aspect in the left sciatic nerve (arrow).

Thumbnail

Figure 9
21-year-old male patient with pain in the right gluteal region and posterior right thigh. Axial T1-weighted slice showing hypertrophy of the right piriformis muscle (dashed arrow) and increased thickness of the ipsilateral sciatic nerve (solid arrow). Normal contralateral piriformis muscle (arrowhead).

Thumbnail

Figure 10
90-year-old patient with lower back pain radiating to the gluteal region and posterior surface of the left thigh. Axial T2-weighted slice (A) and contrastenhanced axial T1-weighted slice (B), showing an abscess in the left piriformis muscle (dashed arrows), resulting in reactive thickening of the ipsilateral sciatic nerve (solid arrow).

Thumbnail

Figure 11
75-year-old female patient with pain in the left gluteal region after a fall from standing height. Sagittal T2-weighted slice (A) and axial T2-weighted slice (B), both with fat saturation, showing diffuse thickening of the left sciatic nerve with a hyperintense signal (arrows), consistent with traumatic neuropathy.

Thumbnail

Figure 12
55-year-old male patient after pelvic radiotherapy for prostate cancer. Coronal T2-weighted slice with fat saturation, showing left sciatic nerve thickening with a hyperintense signal (arrow), consistent with radiation-induced neuritis.

Thumbnail

Figure 13
44-year-old male patient after surgical amputation of the left leg. Coronal T1-weighted slice showing a neuroma at the stump (solid arrow) of the left sciatic nerve (dashed arrows).

Thumbnail

Figure 14
40-year-old male in the early postoperative period after placement of an aortoiliac stent. Axial T2-weighted slice with fat saturation, showing diffuse ischemia of the gluteal musculature (dashed arrows), together with thickening and signal alteration of the left sciatic nerve (solid arrow).

Figure 1 Coronal T1-weighted MRI scan showing the fascicular pattern (long arrow) and perineural fat (short arrows) around the proximal segment of the sciatic nerve.

Figure 2 48-year-old male patient with schwannomatosis. A: Volumetric maximum intensity projection reconstruction of a coronal T2-weighted slice with fat saturation showing schwannomas in both sciatic nerves (arrows). B: Sagittal T2-weighted slice showing root schwannomas (arrows) within the spinal canal.

Figure 3 30-year-old male patient with neurofibromatosis type 1. A: Coronal T2-weighted slice with fat saturation, showing plexiform neurofibromas in both sciatic nerves (arrows). B: Volumetric maximum intensity projection coronal T2-weighted slice with fat saturation, showing neurofibromas at the roots of the lumbosacral plexus (arrows).

Figure 4 68-year-old female patient with increased volume of the right gluteal region and pain in the ipsilateral leg. A: Axial T2-weighted slice showing lipomatosis of the somatic nerve (solid arrow) accompanied by adipose infiltration into the ipsilateral pelvic girdle muscles (dashed arrows). B: Coronal T2-weighted slice of the pelvis, showing increased volume and adipose infiltration into the pelvic girdle muscles (arrows).

Figure 5 32-year-old male patient with a history of neurofibromatosis, presenting with pain in the left leg and enlargement of the left gluteal region. Contrast-enhanced axial T1-weighted slice showing an expansile dumbbell-shaped formation (arrows) on the sciatic nerve in the region of the sciatic notch, consistent with malignant peripheral nerve sheath tumor, as was confirmed by histopathology.

Figure 6 66-year-old male patient with rectal adenocarcinoma. Coronal T2-weighted slice showing an expansile lesion in the pelvic region, consistent with rectal adenocarcinoma, extending to the left sciatic notch (dashed arrows) and involving the right ipsilateral sciatic nerve (solid arrow).

Figure 7 35-year-old male patient with a palpable mass in the left thigh. Axial T1-weighted slice showing a liposarcoma (dashed arrow) in the posterior compartment of the left thigh, compressing and displacing the ipsilateral sciatic nerve (solid arrow).

Figure 8 A: Volumetric maximum intensity projection reconstruction of a coronal T2-weighted slice with fat saturation, showing diffuse thickening of the roots of the lumbosacral plexus (arrows). B: Axial T2-weighted slice with fat saturation, showing a similar aspect in the left sciatic nerve (arrow).

Figure 9 21-year-old male patient with pain in the right gluteal region and posterior right thigh. Axial T1-weighted slice showing hypertrophy of the right piriformis muscle (dashed arrow) and increased thickness of the ipsilateral sciatic nerve (solid arrow). Normal contralateral piriformis muscle (arrowhead).

Figure 10 90-year-old patient with lower back pain radiating to the gluteal region and posterior surface of the left thigh. Axial T2-weighted slice (A) and contrastenhanced axial T1-weighted slice (B), showing an abscess in the left piriformis muscle (dashed arrows), resulting in reactive thickening of the ipsilateral sciatic nerve (solid arrow).

Figure 11 75-year-old female patient with pain in the left gluteal region after a fall from standing height. Sagittal T2-weighted slice (A) and axial T2-weighted slice (B), both with fat saturation, showing diffuse thickening of the left sciatic nerve with a hyperintense signal (arrows), consistent with traumatic neuropathy.

Figure 12 55-year-old male patient after pelvic radiotherapy for prostate cancer. Coronal T2-weighted slice with fat saturation, showing left sciatic nerve thickening with a hyperintense signal (arrow), consistent with radiation-induced neuritis.

Figure 13 44-year-old male patient after surgical amputation of the left leg. Coronal T1-weighted slice showing a neuroma at the stump (solid arrow) of the left sciatic nerve (dashed arrows).

Figure 14 40-year-old male in the early postoperative period after placement of an aortoiliac stent. Axial T2-weighted slice with fat saturation, showing diffuse ischemia of the gluteal musculature (dashed arrows), together with thickening and signal alteration of the left sciatic nerve (solid arrow).

How to cite

copy

Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem Av. Paulista, 37 - 7º andar - conjunto 71, 01311-902 - São Paulo - SP, Tel.: +55 11 3372-4541, Fax: 3285-1690, Fax: +55 11 3285-1690 - São Paulo - SP - Brazil
E-mail: radiologiabrasileira@cbr.org.br

Acompanhe os números deste periódico no seu leitor de RSS

Versão para download de PDF

PDF

Inglês
Português

Versões e tradução automática

Versão original do texto

English
Português

Tradução automática

Google Translator
Microsoft Translator

Como citar

RIS

BIBTEX

Outros formatos de citação e exportação:

SciELO - Scientific Electronic Library Online
Rua Dr. Diogo de Faria, 1087 – 9º andar – Vila Clementino 04037-003 São Paulo/SP - Brasil
E-mail: scielo@scielo.org

Leia a Declaração de Acesso Aberto

Métricas

Sciatic neuropathy: findings on magnetic resonance neurography

PlumX

Mensagem

[1] Mailing address: Dr. Paulo Moraes Agnollitto. Divisão de Radiologia – FMRP-USP. Avenida Bandeirantes, 3900, Monte Alegre. Ribeirão Preto, SP, Brazil, 14048-900. E-mail: agno53@gmail.com