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Utilization, detection rate, and pathologies on lumbosacral plexus MRI: a 25-year institutional experience
Saeed Rahmani1, Christopher Hamilton2, Jeffers K Nguyen2
1Tu Lab for Diagnostic Research, Yale School of Medicine, New Haven, CT Tompkin's East 2, New Haven, CT 06510, United States of America; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, United States of America.
Clinical Imaging
|June 10, 2025
Summary
Lumbosacral plexus MRI, though rarely performed, often reveals abnormalities like tumors and neuropathies. Recognizing these patterns improves diagnosis for conditions mimicking lumbar radiculopathy.
Area of Science:
- Radiology
- Neurology
- Oncology
Background:
- Lumbosacral plexus MRI is infrequently performed, leading to limited radiologist experience with pathologies and imaging trends.
- Lumbosacral plexopathies often present with ambiguous symptoms that can be mistaken for lumbar radiculopathy.
Purpose of the Study:
- To determine the frequency and spectrum of lumbosacral plexus pathologies over 25 years.
- To evaluate clinical indications associated with abnormal lumbosacral plexus MRI findings.
Main Methods:
- Retrospective review of 233 lumbosacral plexus MRI exams from 2000-2024.
- Categorization of pathologies by etiology and analysis of clinical indications and patient demographics.
- Statistical analysis including chi-square and logistic regression to identify predictors of abnormal findings.
Main Results:
- Only 0.024% of all MRIs were lumbosacral plexus exams.
- Abnormalities were found in 27.9% of cases, with nerve sheath tumors, other neoplasms, and compressive neuropathies being most common.
- Motor deficits, neuropathy, and trauma were significantly associated with abnormal findings.
Conclusions:
- Lumbosacral plexus MRI, despite its infrequent use, frequently identifies significant pathologies.
- Understanding imaging trends and common pathologies enhances the interpretation and clinical utility of lumbosacral plexus MRI.
