Variant 6 describes lumbosacral plexopathy in the setting of a known malignancy or post-treatment syndrome; however, plexopathy can be the first clinical presentation of neoplastic disease. Non-neoplastic masses involving the lumbosacral plexus can include hematoma, abscess, aneurysm, amyloidosis [4], and endometriosis [58]. CT Myelography Lumbar Spine There is no relevant literature to support the use of CT myelography of the lumbar spine in the evaluation of nontraumatic lumbosacral plexopathy. Myelography is not routinely performed for the evaluation of nontraumatic plexopathy as it does not evaluate the plexus lateral to the neural foramina. CT Abdomen and Pelvis There is no relevant literature to support the use of abdominal and pelvic CT in the evaluation of nontraumatic lumbosacral plexopathy. CT offers the next highest level of anatomic visualization of the lumbosacral plexus after MRI, and can evaluate for adjacent soft-tissue lesions or tumors that may involve the plexus. CT with IV contrast can be useful for detecting and characterizing soft-tissue masses and tumors, which are in the differential diagnosis of nontraumatic lumbosacral plexopathy and therefore may provide additional information over CT without IV contrast in this setting. CT Lumbar Spine There is no relevant literature regarding the use of CT lumbar spine in the evaluation of nontraumatic lumbosacral plexopathy. CT lumbar spine cannot visualize the preganglionic nerve roots and does not fully evaluate the postganglionic lumbosacral plexus because of its narrow field of view and limited soft-tissue contrast resolution relative to MRI. FDG-PET/CT Whole Body There is no relevant literature to support the use of FDG-PET/CT in the evaluation of nontraumatic lumbosacral plexopathy in the absence of a known malignancy.
Plexopathy. Variant 6 describes lumbosacral plexopathy in the setting of a known malignancy or post-treatment syndrome; however, plexopathy can be the first clinical presentation of neoplastic disease. Non-neoplastic masses involving the lumbosacral plexus can include hematoma, abscess, aneurysm, amyloidosis [4], and endometriosis [58]. CT Myelography Lumbar Spine There is no relevant literature to support the use of CT myelography of the lumbar spine in the evaluation of nontraumatic lumbosacral plexopathy. Myelography is not routinely performed for the evaluation of nontraumatic plexopathy as it does not evaluate the plexus lateral to the neural foramina. CT Abdomen and Pelvis There is no relevant literature to support the use of abdominal and pelvic CT in the evaluation of nontraumatic lumbosacral plexopathy. CT offers the next highest level of anatomic visualization of the lumbosacral plexus after MRI, and can evaluate for adjacent soft-tissue lesions or tumors that may involve the plexus. CT with IV contrast can be useful for detecting and characterizing soft-tissue masses and tumors, which are in the differential diagnosis of nontraumatic lumbosacral plexopathy and therefore may provide additional information over CT without IV contrast in this setting. CT Lumbar Spine There is no relevant literature regarding the use of CT lumbar spine in the evaluation of nontraumatic lumbosacral plexopathy. CT lumbar spine cannot visualize the preganglionic nerve roots and does not fully evaluate the postganglionic lumbosacral plexus because of its narrow field of view and limited soft-tissue contrast resolution relative to MRI. FDG-PET/CT Whole Body There is no relevant literature to support the use of FDG-PET/CT in the evaluation of nontraumatic lumbosacral plexopathy in the absence of a known malignancy.