European Radiology

, Volume 28, Issue 4, pp 1673–1680 | Cite as

Sciatic neurosteatosis: Relationship with age, gender, obesity and height

  • Shayna Ratner
  • Raamis Khwaja
  • Lihua Zhang
  • Yin Xi
  • Riham Dessouky
  • Craig Rubin
  • Avneesh ChhabraEmail author
Magnetic Resonance



To evaluate inter-reader performance for cross-sectional area and fat quantification of bilateral sciatic nerves on MRI and assess correlations with anthropometrics.


In this IRB-approved, HIPPA-compliant study, three readers performed a cross-sectional analysis of 3T lumbosacral plexus MRIs over an 18-month period. Image slices were evaluated at two levels (A and B). The sciatic nerve was outlined using a free hand region of interest tool on PACS. Proton-density fat fraction (FF) and cross-sectional areas were recorded. Inter-reader agreement was assessed using intra-class correlation coefficient (ICC). Spearman correlation coefficients were used for correlations with age, BMI and height and Wilcoxon rank sum test was used to assess gender differences.


A total of 67 patients were included in this study with male to female ratio of 1:1. Inter-reader agreement was good to excellent for FF measurements at both levels (ICC=0.71–0.90) and poor for sciatic nerve areas (ICC=0.08–0.27). Positive correlations of sciatic FF and area were seen with age (p value<0.05). Males had significantly higher sciatic intraneural fat than females (p<0.05).


Fat quantification MRI is highly reproducible with significant positive correlations of sciatic FF and area with age, which may have implications for MRI diagnosis of sciatic neuropathy.

Key Points

MR proton density fat fraction is highly reproducible at multiple levels.

Sciatic intraneural fat is positively correlated with increasing age (p < 0.05).

Positive correlations exist between bilateral sciatic nerve areas and age (p < 0.05).

Males had significantly higher sciatic intraneural fat than females (p < 0.05).


Neurosteatosis MRI Proton density fat fraction Fat quantification Sciatic Neuropathy 


Compliance with ethical standards


The scientific guarantor of this publication is Avneesh Chhabra.

Conflict of interest

The authors of this manuscript declare relationships with the following companies:

AC: Consultant ICON Medical, Royalties: Jaypee, Wolters.

SR, RK, LZ, RD, YX, CR: No disclosures


SR received Medical Student Training in Aging Research (MSTAR) funding from the American Federation for Aging Research. RK received funding from the UT Southwestern Medical Student Summer Research Program.

Statistics and biometry

One of the authors (YX) has significant statistical expertise.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.


• Retrospective

• Diagnostic or prognostic study.

• Performed at one institution

Supplementary material

330_2017_5087_Fig5_ESM.gif (20 kb)
Supplementary Figure 1

Images showing field of view for scout image (A) and axial scans obtained at different levels for mDixon quant. (B) top axial image at L4 level. (C) axial image at ischial spine. (D) bottom image at the lesser trochanter. (GIF 19 kb)

330_2017_5087_MOESM1_ESM.tif (277 kb)
High resolution image (TIFF 277 kb)
330_2017_5087_Fig6_ESM.gif (4 kb)

(GIF 3 kb)

330_2017_5087_MOESM2_ESM.tif (69 kb)
High resolution image (TIFF 69 kb)
330_2017_5087_Fig7_ESM.gif (4 kb)

(GIF 3 kb)

330_2017_5087_MOESM3_ESM.tif (65 kb)
High resolution image (TIFF 65 kb)
330_2017_5087_Fig8_ESM.gif (4 kb)

(GIF 3 kb)

330_2017_5087_MOESM4_ESM.tif (73 kb)
High resolution image (TIFF 73 kb)
330_2017_5087_Fig9_ESM.gif (7 kb)
Supplementary Figure 2

Zoomed images showing the fat fraction measurements. Zoomed image showing the sciatic nerves and their measurements at level A (figure A and B) and level B (figure C and D). (GIF 6 kb)

330_2017_5087_MOESM5_ESM.tif (109 kb)
High resolution image (TIFF 108 kb)
330_2017_5087_Fig10_ESM.gif (7 kb)

(GIF 7 kb)

330_2017_5087_MOESM6_ESM.tif (120 kb)
High resolution image (TIFF 120 kb)
330_2017_5087_Fig11_ESM.gif (7 kb)

(GIF 7 kb)

330_2017_5087_MOESM7_ESM.tif (123 kb)
High resolution image (TIFF 123 kb)
330_2017_5087_Fig12_ESM.gif (8 kb)

(GIF 7 kb)

330_2017_5087_MOESM8_ESM.tif (129 kb)
High resolution image (TIFF 128 kb)
330_2017_5087_Fig13_ESM.gif (6 kb)
Supplementary Figure 3

63-year-old with right buttock pain and sciatica for two years, suspected piriformis syndrome. Axial T2 SPAIR (A) image shows asymmetrically hyperintense right sciatic nerve, even better identified on diffusion image (B). On mDixon quant image (C), notice increased fat fraction of the right sciatic nerve vs left (31.5% vs 27.6%) as well as increased nerve area (0.27 vs 0.25cm2). (GIF 6 kb)

330_2017_5087_MOESM9_ESM.tif (111 kb)
High resolution image (TIFF 110 kb)
330_2017_5087_Fig14_ESM.gif (5 kb)

(GIF 5 kb)

330_2017_5087_MOESM10_ESM.tif (64 kb)
High resolution image (TIFF 64 kb)
330_2017_5087_Fig15_ESM.gif (7 kb)

(GIF 7 kb)

330_2017_5087_MOESM11_ESM.tif (128 kb)
High resolution image (TIFF 127 kb)


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Shayna Ratner
    • 1
  • Raamis Khwaja
    • 1
  • Lihua Zhang
    • 1
    • 2
  • Yin Xi
    • 1
  • Riham Dessouky
    • 1
    • 3
  • Craig Rubin
    • 4
  • Avneesh Chhabra
    • 1
    • 5
    Email author
  1. 1.Department of RadiologyUT Southwestern Medical CenterDallasUSA
  2. 2.RadiologyPeking University Third HospitalBeijingChina
  3. 3.Radiology, Faculty of MedicineZagazig UniversityZagazigEgypt
  4. 4.Geriatric division, Internal MedicineUT Southwestern Medical CenterDallasUSA
  5. 5.Departments of Radiology and Orthopedic Surgery and Musculoskeletal RadiologyUT Southwestern Medical CenterDallasUSA

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