Interpreting imaging studies of peripheral nerve diseases and especially the brachial plexus bp and lumbosacral plexus lsp can be challenging. Traditional lsp protocols include all three imaging planes axial, coronal. Mri lumbosacral plexus wwo protocol positioning image for radiology. Brachial and lumbosacral plexus and peripheral nerves. How to read a brachial plexus mri in the setting of trauma 2020. The brachial plexus is a somatic nerve plexus formed by intercommunications among the ventral rami of the nerve roots c5, c6, c7, c8 and t1 with occasional contributions from c4 and t2. Mri of idiopathic lumbosacral plexopathy request pdf. The lumbar plexus gives rise to the iliohypogastric l1, ilioinguinal l1. It is just as important to be familiar with the endorgan innervations and the surrounding structures, the latter serving as important landmarks. Mr protocol for techs and physicians mr lumbar sacral plexus. The lumbar plexus is a complex neural network formed by the lower thoracic and lumbar ventral nerve roots t12 to l5 which supplies motor and sensory. Highresolution 3t mr neurography of femoral neuropathy. Plexopathy the panel consensus gives its highest rating to contrast enhanced mri of the plexus for patients with suspected acute or chronic plexopathy with or without a history of trauma or in the setting of. In diabetic lumbosacral radiculoplexus neuropathy, lumbosacral radiculoplexus neuropathy, or postsurgical inflammatory neuropathy causing lumbosacral plexopathy, an mri of the lumbosacral plexus may show abnormal images with increased t2 signal in stir of the involved plexus or a normal result 20.
There are scattered case reports depicting femoral nerve pathologic abnormalities using mri 14. Lumbar spine mri performed as part of the mrn ls protocol as well as. Brain mri scan protocols, positioning and planning. Brachial and lumbosacral plexus and peripheral nerves diseases.
The lumbar plexus is formed by the ventral rami of th12, l1, l2, l3 and l4 n. American college of radiology acr appropriateness criteria. Magnetic resonance neurography is a highresolution imaging technique that allows evaluating different neurological pathologies in correlation to clinical and the electrophysiological data. Differentiation between lumbrosacral plexopathy and. The mayo clinic patient data base was searched by diagnostic code for patients diagnosed with herpes zoster between january 1, 1996, and september 30, 2012. Gillard lectures on lumbar disc herniation protrusion. Demystifying mr neurography of the lumbosacral plexus. Ten patients with zosterassociated plexopathy were identified. The branches of the lumbar plexus form the following nerves.
Because of the widespread availability of highfield mri scanners and with everincreasing use of highresolution mr neurography mrn for the evaluation of peripheral nerve pathology 57, it is essential for mri readers to learn. Sagittal ls spine t2 tse a as part of the plexus protocol shows. Ecr 2018 c2547 mr neurography of the lumbosacral plexus. The femoral nerve is the largest branch of the lumbar plexus. Brachial plexus mri protocols and planning indications. The lumbar plexus is formed by the ventral rami of l1, l2, l3, and l4 nerve. Mr imaging of radiationinduced lumbosacral plexopathy, as a rare complication of concomitant chemoradiation for cervical cancer eun taeg hwang. Magnetic resonance neurography is a highresolution imaging technique that. A comprehensive mri protocol for the investigation of peripheral. It creates a muscular shelf on which the kidneys and adrenals rest. Backgroundthe lumbosacral plexus lsp consists of lumbar and sacral plexus.