Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Radio-diagnosis

Aim of work: To determine the value of adding coronal STIR sequence to routine MRI protocol of lumbosacral spine, in patients referred to investigate sciatica or sciatica-like symptoms, aiming at detection of extraspinal causes of sciatica. patients and methods: The study included 217 patients, referred for MRI to investigate sciatica and sciatica-like symptoms. For all patients we added a coronal STIR sequence. We compared the results of analyzing routine MRI protocol vs. combined routine protocol and coronal STIR images. We applied chi-square statistical test to study the prevalence of extra spinal causes of sciatica in patients according to the following features: age, sex, history of trauma, history of neoplasia and presence of any spinal abnormality or nerve root impingement on the routine lumbar MRI. Results: Coronal STIR images revealed additional extraspinal abnormalities in 44 patients (20%). Fifteen (6.9%) of these extraspinal abnormalities were considered to be a definite cause of patients{u2019} symptoms and 24 (11%) were considered equivocal causes of patients{u2019} symptoms. The prevalence of definite extraspinal causes of sciatica was significantly correlated with: age group 20-29 years old (P = 0.002), history of trauma (P = 0.040) or neoplasia (P = 0.013) and absence of any spinal abnormality (P = 0.004) or nerve root impingement on the routine lumbar MRI (P = 0.002). Conclusion: Adding a coronal STIR sequence to the routine MRI protocol is valuable to identify extraspinal causes of sciatica and sciatica- like symptoms especially in young age group, positive history of trauma or neoplasia and absence of spinal abnormalities and neural compromise on routine images

Issued also as CD