CAJ | 학술논문

目的探讨高频超声在诊断臂丛椎间孔内神经根损伤及病变中的价值。方法高频超声检查和诊断27例臂丛椎间孔内神经根撕脱伤和8例臂丛神经根部发出神经鞘瘤，并与手术所见进行比较，随机选择30例无神经外伤的成年人作为正常对照组，观察颈椎椎间孔内神经节及出椎间孔外臂丛神经声像图。结果正常臂丛椎间孔内神经与脊髓连接部、脊神经节的声像图表现为低回声结构，椎动脉长轴及横突根部是超声检查椎间孔内神经根的定位标志。臂丛神经椎间孔内C5～C8神经根和出椎间孔外神经，均能得到良好的显示，显示率为100％。27例臂丛神经椎间孔内根性撕脱伤，超声显示椎间孔内神经节低回声区扩大，连续性中断或消失，出椎间孔外远端神经增粗或椎管旁伴有脑脊液囊肿形成。8例臂丛神经根部发出神经鞘瘤，超声显示椎间孔外脊神经节呈瘤样改变，向神经干延伸，内为束状实性回声，有血供信号。结论高频超声检查臂丛神经椎间孔内神经根性撕脱伤或病变，可以提供有价值的形态学诊断信息。
목적 탐토고빈초성재진단비총추간공내신경근손상급병변중적개치。방법 고빈초성검사화진단27례비총추간공내신경근시탈상화8례비총신경근부발출신경초류，병여수술소견진행비교，수궤선택30례무신경외상적성년인작위정상대조조，관찰경추추간공내신경절급출추간공외비총신경성상도。결과 정상비총추간공내신경여척수련접부、척신경절적성상도표현위저회성결구，추동맥장축급횡돌근부시초성검사추간공내신경근적정위표지。비총신경추간공내C5～C8신경근화출추간공외신경，균능득도량호적현시，현시솔위100％。27례비총신경추간공내근성시탈상，초성현시추간공내신경절저회성구확대，련속성중단혹소실，출추간공외원단신경증조혹추관방반유뇌척액낭종형성。8례비총신경근부발출신경초류，초성현시추간공외척신경절정류양개변，향신경간연신，내위속상실성회성，유혈공신호。결론 고빈초성검사비총신경추간공내신경근성시탈상혹병변，가이제공유개치적형태학진단신식。
Objective To evaluate the application of high-resolution ultrasonography in the diagnosis of nerve root lesion of cervical vertebra intervertebral foramen part. Methods Twenty-seven patients with root avulsion injury of brachial plexus intervertebral part and 8 patients with schwannoma of brachial plexus root were examined with high-resolution ultrasonography. Thirty healthy volunteers were involved for the sonographic imagings of normal brachial plexus intervertebral part. The ultrasound findings of the patients before operation were compared with surgical outcomes. Results The normal intervertebral part of brachial plexus were shown as hypoechoic tubular strucuture, which could be identified with cervical artery and transverse process used as landmarks for the intervertebral part of brachial plexus root. The detection ratios of normal intervertebral part for C5-C8 and outside part of braehial plexus were 100％. In 27 patients with root avulsion injury of intervertebral brachial plexus, the intervertebral nerve root were enlarged as hypoechoic area, with nerve dissected partly or disappearing, distal nerve parts outside the intervertebral foramen swelling, edema,or cerebrospinal fluid assembling as cystic masses. In 8 patients with schwannoma of brachial plexus root part, the spinal ganglia outside intervertebral foramen were shown as tumor-like hypoechoic mass, with blood supply shown inside. Conclusions High-resolution ultrasonography is of great value for early and convenient diagnosis of root avulsion injury and mass of brachial plexus intervertebral part, especially in community hospitals,which could provide important information for clinical therapy.