Kazan medical journalKazan medical journalКазанский медицинский журнал0368-48142587-9359Eco-Vector50878110.17816/KMJ508781ReviewsОбзорыReview ArticlePossibilities of magnetic resonance imaging in visualizing the pudendal nerve in normal and pathological conditionsВозможности магнитно-резонансной томографии в визуализации полового нерва в норме и при патологииhttps://orcid.org/0000-0002-3299-1924BeloborodovVladimir A.БелобородовВладимир Анатольевич
Russian Federation

M.D., D. Sci. (Med.), Prof., Head of Depart., Depart. of General Surgery

докт. мед. наук, проф., зав. каф., каф. общей хирургии

BVA555@yndex.ruhttps://orcid.org/0000-0001-9039-9147StepanovIvan A.СтепановИван Андреевич
Russian Federation

M.D., Ass., Depart. of General Surgery

асс., каф. общей хирургии

edmoilers@mail.ruhttps://orcid.org/0009-0001-9657-0125RylloGeorgiy A.РыллоГеоргий Андреевич
Russian Federation

M.D., Oncourologist

врач-онкоуролог

Gosharyllo@gmail.comIrkutsk State Medical UniversityИркутский государственный медицинский университетKharlampiev ClinicХарлампиевская клиникаLeningrad Regional Oncology Dispensary named after L.D. RomanЛенинградский областной онкологический диспансер им. Л.Д. Романа031120230202202410511101172606202322092023Copyright ©; 2024, Eco-VectorCopyright ©; 2024, Эко-Вектор2024Eco-VectorЭко-Векторhttp://creativecommons.org/licenses/by-nc-sa/4.0https://kazanmedjournal.ru/kazanmedj/article/view/508781

Until recently, imaging of peripheral nerves was limited from a technical point of view, as there was no established “gold standard” study protocol for the purpose of qualitative visualization of nerve trunks in normal and pathological conditions. With technical advances in magnetic resonance imaging and the advent of specialized high-resolution magnetic resonance neurography, it has become possible to visualize peripheral nerves of varying diameters. A literature search in the Pubmed, Medline, EMBASE, Cochrane Library, and eLibrary databases demonstrated the presence of several studies examining the capabilities of magnetic resonance imaging in visualizing the pudendal nerve in normal and pathological conditions. It must be emphasized that the results of these studies are consistent and largely complement each other. A generalization of the available data on the capabilities of magnetic resonance neurography of the pudendal nerve was the impetus for writing this literature review. Magnetic resonance neurography is a tissue-specific imaging method optimized for assessing the condition of peripheral nerves, including changes in the morphology of their bundle structure, signal, the diameter and length of nerve trunks, which can be caused by both anatomical features and pathological processes. Three-dimensional (3D) imaging is critical for studying the topography of peripheral nerves, identifying areas of compression or traumatic injury, and for preoperative planning. Magnetic resonance imaging in certain modes and sections allows to clearly visualize the pudendal nerve along almost its entire length, determine the nature of its branching and the features of its topographic and anatomical location. The anatomical characteristics of the pudendal nerve and its pathological changes obtained using magnetic resonance neurography can be used in everyday clinical practice by urologists, obstetricians-gynecologists and neurosurgeons for planning surgical interventions.

До недавнего времени визуализация периферических нервов была ограничена с технической точки зрения, так как отсутствовал установленный «золотой стандарт» протокола исследования с целью качественной визуализации нервных стволов в норме и при патологии. Благодаря техническим достижениям в области магнитно-резонансной томографии и с появлением специализированной магнитно-резонансной нейрографии с высоким разрешением стало возможным визуализировать периферические нервы различных диаметров. Поиск литературных источников в базах данных Pubmed, Medline, EMBASE, Cochrane Library и eLibrary продемонстрировал наличие нескольких исследований, посвящённых изучению возможностей магнитно-резонансной томографии в визуализации полового нерва в норме и при патологии. Необходимо подчеркнуть, что результаты указанных исследований согласуются и во многом дополняют друг друга. Обобщение имеющихся данных о возможностях магнитно-резонансной нейрографии полового нерва и явилось побудительным моментом к написанию настоящего литературного обзора. Магнитно-резонансная нейрография представляет собой тканеспецифический метод визуализации, оптимизированный для оценки состояния периферических нервов, включая изменения морфологии их пучкового строения, сигнала, а также диаметра и длины нервных стволов, что может быть обусловлено как анатомическими особенностями, так и патологическими процессами. Трёхмерная (3D) визуализация имеет решающее значение для изучения топографии периферических нервов, выявления областей их компрессии или травматического повреждения, а также для предоперационного планирования. Магнитно-резонансная томография в определённых режимах и срезах позволяет чётко визуализировать половой нерв практически на всём его протяжении, определить характер его ветвления и особенности топографо-анатомического расположения. Анатомометрические характеристики полового нерва и его патологические изменения, полученные с помощью магнитно-резонансной нейрографии, могут быть использованы в повседневной клинической практике урологов, акушеров-гинекологов и нейрохирургов для планирования оперативных вмешательств.

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