CAJ | 학술논문

目的探讨高频超声在诊断臂丛神经节前和节后损伤中的价值.方法高频超声检查和诊断31例创伤性臂丛神经节前和节后损伤,并与手术所见进行比较,随机选择17例无神经外伤的成年人作为正常对照组,观察正常臂丛神经的超声图像.结果高频超声显示斜角肌间隙和锁骨下动脉是臂丛神经检查的重要解剖标志;C5～ C7和上、中干显示率为100%(17/17),C8、T1和下干显示率为88.3%(15/17),19例臂丛神经节前损伤显示,臂丛神经根发出处变细,连续性中断或消失,椎间孔外远端神经增粗或椎管旁伴有脑脊液囊性聚集.12例臂丛神经节后损伤显示臂丛神经根部发出内径正常,形态走行连续,远端神经干及束平面不同程度神经增粗、水肿粘连.结论高频超声可作为检查臂丛神经节前、节后损伤的首选方法之一,为临床手术提供有价值的影像学信息,值得临床推广应用.
목적 탐토고빈초성재진단비총신경절전화절후손상중적개치.방법 고빈초성검사화진단31례창상성비총신경절전화절후손상,병여수술소견진행비교,수궤선택17례무신경외상적성년인작위정상대조조,관찰정상비총신경적초성도상.결과 고빈초성현시사각기간극화쇄골하동맥시비총신경검사적중요해부표지;C5～ C7화상、중간현시솔위100%(17/17),C8、T1화하간현시솔위88.3%(15/17),19례비총신경절전손상현시,비총신경근발출처변세,련속성중단혹소실,추간공외원단신경증조혹추관방반유뇌척액낭성취집.12례비총신경절후손상현시비총신경근부발출내경정상,형태주행련속,원단신경간급속평면불동정도신경증조、수종점련.결론 고빈초성가작위검사비총신경절전、절후손상적수선방법지일,위림상수술제공유개치적영상학신식,치득림상추엄응용.
Objective To evaluate the application of high-resolution ultrasonography in the diagnosis of preganglionic and postganglionic injuries of brachial plexus.Methods 31 patients with suspected brachial plexus injuries were examined with high-resolution ultrasonography.17 healthy volunteers were involved to observe the normal sonographic imagings of brachial plexus.The ultrasound findings of the patients before operation were compared with surgical findings.Results The scalenus space and subclavian artery were detected to be useful anatomy landmarks for the mapping of brachial plexus.The detection ratios of different parts of normal brachial plexus were 100% for C5-C7 and upper or middle trunk(17/17),and 88.3% for C8,T1 and lower trunk.In 31 patients with injury of brachial plexus,19 were found to have preganglionic injuries and 12 were found to have postganglionic injuries.In 19 patients with preganglionic injuries,the roots of brachial plexus became thin,dissected partly or disappeared,outside of the intervertebral foramen the distal parts of nerve swelled,or cerebrospinal fluid assembled as cystic masses.In 12 patients with postganglionic injuries of brachial plexus,the sizes and shapes of roots were all normal,but the distal parts at trunks or bundles appeared swelling,edema or adhesion.Conclusions High-resolution ultrasonography is the first choice in the diagnosis of preganglionic and postganglionic injuries of brachial plexus.The application should be popularized.