MR neurography with multiplanar reconstruction of 3D MRI datasets: an anatomical study and clinical applications

Extracranial MR neurography has so far mainly been used with 2D datasets. We investigated the use of 3D datasets for peripheral neurography of the sciatic nerve. A total of 40 thighs (20 healthy volunteers) were examined with a coronally oriented magnetization-prepared rapid acquisition gradient echo sequence with isotropic voxels of 1 × 1 × 1 mm and a field of view of 500 mm. Anatomical landmarks were palpated and marked with MRI markers. After MR scanning, the sciatic nerve was identified by two readers independently in the resulting 3D dataset. In every volunteer, the sciatic nerve could be identified bilaterally over the whole length of the thigh, even in areas of close contact to isointense muscles. The landmark of the greater trochanter was falsely palpated by 2.2 cm, and the knee joint by 1 cm. The mean distance between the bifurcation of the sciatic nerve and the knee-joint gap was 6 cm (±1.8 cm). The mean results of the two readers differed by 1–6%. With the described method of MR neurography, the sciatic nerve was depicted reliably and objectively in great anatomical detail over the whole length of the thigh. Important anatomical information can be obtained. The clinical applications of MR neurography for the brachial plexus and lumbosacral plexus/sciatic nerve are discussed.