Demystifying MR Neurography of the Lumbosacral Plexus: From Protocols to Pathologies

Figure 7

34-year-old male with history of left hip pain with radiation to lower left limb after soccer training. MRN images in axial T1 (a), axial T2 fat suppression (b), coronal T2 3D SPACE (c), and coronal STIR 3D SPACE (d) show a heterogeneous tissue (solid arrow) with high intensity in T2, with low signal foci in perineural region posterior to the left L5 nerve root (wavy arrow) anteriorly to the left sacral wing. There is thickening and abnormal signal intensity of the left nerve root of L5 (arrowhead), as well as of fascicles of the nerve to the proximal thigh segment, with a high T2 signal and postcontrast enhancement (neuropathy). The appearance is compatible with L5-S1 left extraforaminal disc extrusion material, with extensive lower migration and neural compression.

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