中华手外科杂志
中華手外科雜誌
중화수외과잡지
CHINESE JOURNAL OF HAND SURGERY
2011年
1期
41-44
,共4页
臂丛%损伤%磁共振%诊断
臂叢%損傷%磁共振%診斷
비총%손상%자공진%진단
Brachial plexus%Injuries%MRI%Diagnosis
目的 探讨磁共振(magnetic resonance imaging,MRI)对臂丛神经节前损伤诊断的准确率及影响因素.方法 运用MRI对27例臂丛神经损伤的患者进行多序列扫描,将影像学诊断与手术所见及术中神经电生理检测结果进行比较,统计各神经根损伤诊断的准确率.结果 臂丛神经节前损伤MRI表现的直接征象:冠状面、横断面或多平面重建均见脊神经前后根消失或连续性的中断,脊髓移位(中心点偏移＞1.5mm);间接征象:创伤性脊膜囊肿,椎管内囊状脑脊液积聚,脊髓变形或移位,"黑线征",脊柱旁肌肉信号异常、强化.臂丛神经节后损伤MRI表现的直接征象:神经增粗或离断、扭曲,伴或不伴T2WI信号增高,创伤性神经瘤形成;间接征象:去神经化肌肉的显示.MRI对臂丛C5～T1各神经根撕脱损伤诊断的准确率分别是59.3%、85.2%、100%、88.9%和92.6%.结论 MRI对臂丛各神经根节前损伤的诊断效能不同,影像诊断应与临床及神经电生理检测相结合.
目的 探討磁共振(magnetic resonance imaging,MRI)對臂叢神經節前損傷診斷的準確率及影響因素.方法 運用MRI對27例臂叢神經損傷的患者進行多序列掃描,將影像學診斷與手術所見及術中神經電生理檢測結果進行比較,統計各神經根損傷診斷的準確率.結果 臂叢神經節前損傷MRI錶現的直接徵象:冠狀麵、橫斷麵或多平麵重建均見脊神經前後根消失或連續性的中斷,脊髓移位(中心點偏移＞1.5mm);間接徵象:創傷性脊膜囊腫,椎管內囊狀腦脊液積聚,脊髓變形或移位,"黑線徵",脊柱徬肌肉信號異常、彊化.臂叢神經節後損傷MRI錶現的直接徵象:神經增粗或離斷、扭麯,伴或不伴T2WI信號增高,創傷性神經瘤形成;間接徵象:去神經化肌肉的顯示.MRI對臂叢C5～T1各神經根撕脫損傷診斷的準確率分彆是59.3%、85.2%、100%、88.9%和92.6%.結論 MRI對臂叢各神經根節前損傷的診斷效能不同,影像診斷應與臨床及神經電生理檢測相結閤.
목적 탐토자공진(magnetic resonance imaging,MRI)대비총신경절전손상진단적준학솔급영향인소.방법 운용MRI대27례비총신경손상적환자진행다서렬소묘,장영상학진단여수술소견급술중신경전생리검측결과진행비교,통계각신경근손상진단적준학솔.결과 비총신경절전손상MRI표현적직접정상:관상면、횡단면혹다평면중건균견척신경전후근소실혹련속성적중단,척수이위(중심점편이＞1.5mm);간접정상:창상성척막낭종,추관내낭상뇌척액적취,척수변형혹이위,"흑선정",척주방기육신호이상、강화.비총신경절후손상MRI표현적직접정상:신경증조혹리단、뉴곡,반혹불반T2WI신호증고,창상성신경류형성;간접정상:거신경화기육적현시.MRI대비총C5～T1각신경근시탈손상진단적준학솔분별시59.3%、85.2%、100%、88.9%화92.6%.결론 MRI대비총각신경근절전손상적진단효능불동,영상진단응여림상급신경전생리검측상결합.
Objective To analyze the diagnostic accuracy of MRI in determining brachial plexus preganglionic injury and the factors that affect the accuracy. Methods Twenty-seven patients who presented with brachial plexus root avulsion injuries underwent MRI scanning with multiple sequences before the operation.Images of MRI were reviewed for features that would lead to the diagnosis of a preganglionic injury. MRI diagnosis was then verified and compared with surgical findings and electrophysiological diagnosis. The accuracy rate for individual nerve root avulsion was calculated. Results There were direct signs and indirect signs of MRI features that indicated preganglionic injuries. The direct signs included disappearance or loss of continuity of the ventral and dorsal rootlets of the spinal nerve on coronal plane, axial plane or multiplanal reconstruction, and spinal cord shift (midline shift ＞ 1.5 mm). The indirect signs included traumatic pseudomeningocele, CSF collection in the vertebral canal, spinal cord deformation or shift, "black line" sign, and abnormal signals in the paraspinal muscles. Direct MRI signs of postganglionic injuries included thickening, rupture or distortion of the nerve root, with or without increase signal in T2 weighted images, and neuroma formation. Muscle denervation was also an indirect sign for postganglionic injury. The diagnostic accuracy by MRI of C5 to T1 avualsion was 59.3%,85.2%,100%,88.9% and 92.6% respectively. Conclusion The capability of MRl to evaluate lesions of each nerve root is different. A diagnosis should be made combining MRI, electrophysiological and clinical findings.
