MRI co-ordinator Queensland Xray Brisbane

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The following message is from the latest in MRI technique to image the Pudendal nerves: We have permission to post the radioligist's details.

With regards to imaging the pudendal nerve with MRI - it is possible. MRI can definitely image nerves and their course through anatomy. We have been imaging with MRI to diagnose piriformis syndrome for a considerable time and have extrapolated this technique for imaging the pudendal nerve.

We have just recently imaged 3 cases of suspected PNE for Peter. We did not find evidence of PNE on these cases. What I would like is a positive case of entrapment to verify the technique that we are using. We are using a 3T system, MRN sequences, diffusion sequences and 3D datasets to track the course of the nerve. We have been able to track the course of the nerve from S2 down into the perineum in normal patients as well as these 3 patients, looking at the two common areas of entrapment - alcocks canal and between the SS ligament and ST ligament.

With the MRN technique you are looking for increased fluid and thickening within the nerve sheath, and by using this technique (sensitive to increased water content in nerves) you are making everything else dark (using heavy fat suppression), making the abnormal nerve 'stand out'.
What is essential for optimal imaging of PNE - site with experience in interpreting and imaging PNE, MRI imaging on a 3T platform is preferred, utilising 3D, MRN, and diffusion sequences.

I think with more cases in this area (and hopefully show some positive cases) we will be able to provide a viable option for imaging PNE patients.

Sincerely,

Dominic


Dominic Kennedy | MRI Coordinator | Queensland X-Ray
Ph:07 34210421 | Mob: 0407925238 | Fax: 07 38475014 | E-mail: dominic.kennedy@qldxray.com.au