• Korean Journal of Radiology
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• 제24권11호
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• pp.1114-1130
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• 2023

Magnetic resonance neurography (MRN) is increasingly used to visualize peripheral nerves in vivo. However, the implementation and interpretation of MRN in the brachial and lumbosacral plexi are challenging because of the anatomical complexity and technical limitations. The purpose of this article was to review the clinical context of MRN, describe advanced magnetic resonance (MR) techniques for plexus imaging, and list the general categories of utility of MRN with pertinent imaging examples. The selection and optimization of MR sequences are centered on the homogeneous suppression of fat and blood vessels while enhancing the visibility of the plexus and its branches. Standard 2D fast spin-echo sequences are essential to assess morphology and signal intensity of nerves. Moreover, nerve-selective 3D isotropic images allow improved visualization of nerves and multiplanar reconstruction along their course. Diffusion-weighted and diffusion-tensor images offer microscopic and functional insights into peripheral nerves. The interpretation of MRN in the brachial and lumbosacral plexi should be based on a thorough understanding of their anatomy and pathophysiology. Anatomical landmarks assist in identifying brachial and lumbosacral plexus components of interest. Thus, understanding the varying patterns of nerve abnormalities facilitates the interpretation of aberrant findings.

• Clinical Pain
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• 제20권1호
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• pp.53-57
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• 2021

We report a case of neurolymphomatosis of lumbosacral plexus. A 63-year-old man, who had no past history except for diabetes mellitus, complained of severe pain and weakness on left lower extremity. Idiopathic lumbosacral plexopathy was diagnosed by electromyography. There were no abnormal findings except for FDG-PET/CT and MRI. They showed high uptake and thickening lesion in sciatic nerve and sacral plexus. However, about 7 months later, mass like lesion in left thigh was detected by FDG-PET/CT and MRI. Also, multiple hypermetabolic lesions were found in brain. Through brain biopsy, diffuse large B-cell lymphoma was confirmed. When a patient with idiopathic lumbosacral plexopathy complains of severe pain, it is necessary to consider FDG-PET/CT and MRI to differentiate neurolymphomatosis, even in patients who have no past history of lymphoma before. Especially, if FDG-PET/CT and MRI show sciatic and/or lumbosacral plexus lesion, neurolymphomatosis of lumbosacral plexus should be considered.

• 대한영상의학회지
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• 제83권6호
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• pp.1273-1285
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• 2022

목적 자기공명신경조영술은 말초신경을 시각화하는 데 최적화된 영상 기법이다. 본 주제 범위 문 헌고찰에서는 요천추신경총에서 자기공명신경조영술의 프로토콜을 조사하고, 요추신경총 질환 환자에서 자기공명신경조영술의 임상적 이득에 대해 고찰하고자 한다. 대상과 방법 두 개의 의료 데이터베이스에서 2021년 9월까지 영문으로 출판된 논문에 대해 체계적 문헌검색을 수행하였다. 'Magnetic resonance Imaging', 'lumbosacral plexus', 'neurologic disease'를 포함하는 55편의 논문을 분석하였다. 결과 요천추신경총의 자기공명신경조영술은 말초 신경 질환의 분포 확인, 신경 주변 주사시 유도, 좌골신경통 환자에서는 척추외 원인 평가에 유용하였다. 혈관억제 기법이 적용된 3차원 단시간 반전회복 고속 스핀에코 영상이 주된 자기공명신경조영술 기법이었다. 결론 향후 요천추신경총의 자기공명신경조영술에 대한 기술적 성숙과 임상적 유용성에 대한 검증이 필요하다.

• Investigative Magnetic Resonance Imaging
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• 제24권1호
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• pp.46-50
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• 2020

Radiation-induced lumbosacral plexopathy (RILSP) is an uncommon complication of pelvic radiotherapy that can result in different degrees of sensory and motor deficits. An age 59 female with cervical cancer, who had received combined chemotherapy and radiation therapy two years before, presented with bilaterally symmetric lower-extremity weakness and tingling sensation. The magnetic resonance imaging showed diffuse T2 bright signal intensity and mild enhancement along the bilateral lumbosacral plexus with no space-occupying masses. RILSP was diagnosed after the exclusion of malignant and inflammatory plexopathies.

• Journal of Korean Neurosurgical Society
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• 제38권3호
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• pp.234-237
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• 2005

The neuropathic pain caused by lumbosacral plexopathy as a sequela to extensive pelvic and sacral fractures is rare because many posttraumatic cases remain undiagnosed as a result of the high mortality associated with these types of injury and because of the survivors of multiple trauma, including pelvic fractures, frequently have an incomplete work-up. Although surgical treatments for medically refractory lumbosacral plexus avulsion pain have been reported, an effective surgical technique for pain relief in lumbosacral plexopathy has not been well documented. We describe the effectiveness of spinal cord stimulation [SCS] in a patient suffering from severe neuropathic pain caused by lumbosacral plexopathy after an extensive pelvic fracture.

• Journal of Korean Neurosurgical Society
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• 제42권6호
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• pp.475-477
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• 2007

Choroid plexus papillomas (CPPs) are typically considered as benign tumors, with a favorable long-term prognosis. Drop metastasis of CPP into the spinal subarachnoid space is rare. We report a 42-year-old woman who presented with headache and back pain 6 years after removal of a posterior fossa CPP. Magnetic resonance imaging revealed mass lesions in the lumbosacral subarachnoid space and recurrent intracranial tumor. The lesions were resected and histologically diagnosed was CPP. We consider that CPP can spread via cerebrospinal fluid pathways and cause spinal drop metastasis. Therefore, it is necessary to evaluate the whole spinal axis and to perform periodic follow-up examinations in patients with CPP.

• Journal of Yeungnam Medical Science
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• 제41권2호
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• pp.120-127
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• 2024

Background: Physiatrists are facing with survivors from disasters in both the acute and chronic phases of muscle and nerve injuries. Similar to many other clinical conditions, neuromusculoskeletal ultrasound can play a key role in the management of such cases (with various muscle/nerve injuries) as well. Accordingly, in this article, a recent single-center experience after the Turkey-Syria earthquake will be rendered. Methods: Ultrasound examinations were performed for various nerve/muscle lesions in 52 earthquake victims referred from different cities. Demographic features, type of injuries, and applied treatment procedures as well as detailed ultrasonographic findings are illustrated. Results: Of the 52 patients, 19 had incomplete peripheral nerve lesions of the brachial plexus (n=4), lumbosacral plexus (n=1), and upper and lower limbs (n=14). Conclusion: The ultrasonographic approach during disaster relief is paramount as regards subacute and chronic phases of rehabilitation. Considering technological advances (e.g., portable machines), the use of on-site ultrasound examination in the (very) early phases of disaster response also needs to be on the agenda of medical personnel.

• The Korean Journal of Pain
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• 제9권2호
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• pp.426-429
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• 1996

Complex regional pain syndrome Type II(CRPS) can be diagnosed by new IASP criteria in 1994. Sympathetically maintained pain may or may not be present in a patient with complex regional pain syndrome. We experienced a CRPS Type II patient who has sympathetically maintained pain as a major painful nature developed after right multiple iliac bone fracture, right femoral artery thrombosis and lumbosacral plexus injury. Combination treatment with L2, L3, L4 sympathetic ganglion block and continuous lower thoracic epidural block for 30 days were tried to get long term effect. The patient had signs of successful. sympathetic denervation of the right foot. After that pain relief was sustained until three month later.

• 대한근전도전기진단의학회지
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• 제20권2호
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• pp.124-129
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• 2018

Neuralgic amyotrophy (NA) is an idiopathic disease characterized by muscular atrophy accompanied by neuralgia, where acute pain in the limb, mostly including the shoulders, leads to muscle weakeness and atrophy in the limb days to weeks after the onset of pain. Although its exact pathogenesis is unknown, genetic and nongenetic factors, such as infection, surgery, and trauma are suspected contributors. We report this case as we diagnosed NA of the right lower limb via enhanced MRI as well as EMG and have followed up the patient's prognosis and radiologic changes for one and a half years. In addition, the patient had been diagnosed with neuropsychiatric disorders, such as major depressive disorder and somatic symptom disorder.

• 대한물리의학회지
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• 제16권1호
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• pp.1-7
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• 2021

PURPOSE: The purpose of this study is to conduct inter-rater and intra-rater reliability tests in patients with low back pain (LBP) using the prone instability test (PIT) and side-lying instability test (SIT). We have analyzed the Korean version Oswestry disability index (K-ODI) correlations and radiograph finding (RF) for validity. METHODS: Individuals (n = 51) (mean age of 40.27 ± 13.28) with LBP for at least over a week were recruited, together with two participating physical therapist examiners. The measurement consisted of PIT, PST, K-ODI, and RF. Sensitivity (Sn), specificity (Sp), positive predictive value, negative predictive value, prevalence index, agreement %, Cohen's kappa, and prevalence-adjusted bias-adjusted kappa (PABAK) were calculated. The PIT and SIT were compared with RF for validity analysis, while PIT, SIT, K-ODI, and RF were calculated for the correlation analysis. RESULTS: The intra-rater reliability test measured for the PIT (kappa = .79, PABAK = .88) and SIT (kappa = .73, PABAK = .84), and inter-rater reliability test measured for the SIT (kappa = .80, PABAK = .88) showed good agreements. The PIT (Sn = .65, Sp = .63) and SIT validities (Sn = .68, Sp = .70) were compared with RF, showing a significant correlation in PIT and RF (r = .69), SIT and RF (r = .73), and PIT and K-ODI (r = .53). CONCLUSION: The SIT is a more comfortable position test than the PIT in patients. Both PIT and SIT have acceptable reliability and validity.