3T magnetic resonance neurography of pudendal nerve with cadaveric dissection correlation

作     者：Avneesh Chhabra Courtney A McKenna Vibhor Wadhwa Gaurav K Thawait John A Carrino Gary P Lees A Lee Dellon 

作者机构：Musculoskeletal RadiologyUniversity of Texas Southwestern Medical Center the Russell H.Morgan Department of Radiology and Radiological Science Johns Hopkins University School of Medicine Department of Art As Applied to Medicine Johns Hopkins University Department of Radiology University of Arkansas for Medical Sciences Department of Radiology and Imaging Hospital for Special Surgery Department of Plastic Surgery and NeurosurgeryJohns Hopkins University School of Medicine 

出 版 物：《World Journal of Radiology》 (世界放射学杂志（英文版）（电子版）)

年 卷 期：2016年第8卷第7期

页      面：700-706页

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 100207[医学-影像医学与核医学] 1002[医学-临床医学] 1001[医学-基础医学(可授医学、理学学位)] 08[工学] 1010[医学-医学技术（可授医学、理学学位）] 100101[医学-人体解剖与组织胚胎学] 1009[医学-特种医学] 10[医学] 

基　　金：GE-AUR (GERRAF) Siemens Medical Solutions Integra Life Sciences 

主　　题：Pudendal nerve Cadaver Magnetic resonance neurography Chronic pelvic pain 

摘      要：AIM: To evaluate the pudendal nerve segments that could be identified on magnetic resonance neurography(MRN) before and after surgical marking of different nerve ***: The hypothesis for this study was that pudendal nerve and its branches would be more easily seen after the surgical nerve marking. Institutional board approval was obtained. One male and one female cadaver pelvis were obtained from the anatomy board and were scanned using 3 Tesla MRI scanner using MR neurography sequences. All possible pudendal nerve branches were identified. The cadavers were then sent to the autopsy lab and were surgically dissected by a peripheral nerve surgeon and an anatomist to identify the pudendal nerve branches. Radiological markers were placed along the course of the pudendal nerve and its branches. The cadavers were then closed and rescanned using the same MRN protocol as the premarking scan. The remaining pudendal nerve branches were attempted to be identified using the radiological markers. All scans were read by an experienced musculoskeletal ***: The pre-marking MR Neurography scans clearly showed the pudendal nerve at its exit from the lumbosacral plexus in the sciatic notch, at the level of the ischial spine and in the Alcock s Canal in both cadavers. Additionally, the right hemorrhoidal branch could be identified in the male pelvis cadaver. The perineal and distal genital branches could not be identified. On post-marking scans, the markers were used as identifiable structures. The location of the perineal branch, the hemorroidal branch and the dorsal nerve to penis(in male cadaver)/clitoris(in female cadaver) could be seen. However, the visualization of these branches was suboptimal. The contralateral corresponding nerves were poorly seen despite marking on the surgical side. The nerve was best seen on axial T1W and T2W SPAIR images. The proximal segment could be seen well on 3D DW PSIF sequence. T2W SPACE was not very useful in visualizat