Incremental value of magnetic resonance neurography of Lumbosacral plexus over non-contributory lumbar spine magnetic resonance imaging in radiculopathy: A prospective study

Figure 1 Right femoral neuropathy. A 22-year-old man with prior motor vehicle accident and right iliac bone surgery presented with severe right anterior leg pain and partial limb weakness, ongoing for more than 1 yr. Outside MR imaging of LS spine was normal and EMG was negative. Outside right hip MRI was also reported normal. Sagittal LS spine T2 TSE (A) as part of the plexus protocol shows normal imaging appearance. Axial T1W (B) image shows irregular fibrosis along the expected course of the right femoral nerve with ipsilateral iliopsoas atrophy (arrow). Axial MIP reconstructed 3D IR TSE (C) image shows focal loss of signal along the right femoral nerve due to fibrous entrapment (arrows). Axial T2 SPAIR (D) and DTI tensor images (E) show the abnormal signal size alteration of the right femoral nerve (arrows). Axial T1W image of the lower pelvis (F) shows right quadriceps atrophy (arrow). Right Femoral Nerve- Mean FA = 0.45 Mean ADC = 1320 mm2/s; Left Femoral Nerve- Mean FA = 0.77 Mean ADC = 1136.8 mm2/s. MR: Magnetic resonance; LS: Lumbosacral; EMG: Electromyogram; TSE: Turbo spin echo; MRI: Magnetic resonance imaging; T: Tesla; MIP: Maximum intensity projection; 3D: 3-Dimensional; IR: Inversion recovery; SPAIR: Spectral adiabatic inversion recovery; DTI: Diffusion tensor imaging; FA: Fractional anisotropy; ADC: Apparent diffusion coeffcient.