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The use of magnetic resonance imaging to evaluate the accuracy of a handheld ultrasound machine in localizing the sciatic nerve in the popliteal fossa
  1. Brian D. Sites, M.D.,
  2. John D. Gallagher, M.D.,
  3. Ivan Tomek, M.D.,
  4. Yvonne Cheung, M.D. and
  5. Michael L. Beach, M.D., Ph.D.
  1. From the Department of Anesthesiology (B.D.S., J.D.G., M.L.B.), Dartmouth Medical School, Dartmouth Hitchcock Medical Center, Lebanon, NH.
  2. Department of Radiology (Y.C.), Dartmouth Medical School, Dartmouth Hitchcock Medical Center, Lebanon, NH.
  3. Department of Orthopedic Surgery, Dartmouth Medical School, Dartmouth Hitchcock Medical Center, Lebanon, NH.
  1. Reprint requests: Brian D. Sites, M.D., Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756. E-mail: brian.sites{at}


Background and objective Ultrasound has become an increasingly popular modality in facilitating the performance of peripheral nerve blocks. There is a paucity of data describing techniques of ultrasound-guided sciatic nerve blocks. By using magnetic resonance imaging (MRI) as a gold standard, the objective of this study was to describe the ability of a handheld ultrasound machine to accurately locate the sciatic nerve.

Methods Ten patients were prospectively enrolled and placed in the prone position. By using a 4- to 7-MHz ultrasound transducer, the sciatic nerve was visualized in short axis between 5 to 10 cm above the popliteal crease. The distance from the skin to the nerve was measured by ultrasound, and a MRI lucent marker was placed at this site. This process was repeated in one additional location. The patient was then placed supine in the MRI scanner and short-axis T1-weighted images were obtained. On the MRI image, we recreated the 2 lines extending down from the markers using the distances previously measured by ultrasound. The point of intersection of these 2 lines represents the ultrasound-determined location of the sciatic nerve, which was then compared with the midpoint of the nerve complex on MRI.

Results The sciatic nerve was easily visualized by ultrasound in all 10 patients. MRI showed the division of the sciatic nerve in 9 out of 10 patients. Ultrasound was able to confirm this division in 7 patients. The mean distance between the MRI and ultrasound midpoint location of the sciatic nerve was 2.9 ± 1.3 mm.

Conclusions The data presented here suggest that the specific ultrasound machine evaluated in this study can accurately localize the sciatic nerve in the popliteal fossa.

  • Ultrasound
  • MRI
  • Anatomy
  • Popliteal
  • Nerve block.

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  • Presented in part as an abstract for the American Society of Anesthesiologists annual meeting, Las Vegas, NV, October 2004.