实用手外科杂志
實用手外科雜誌
실용수외과잡지
CHINESE JOURNAL OF PRACTICAL HAND SURGERY
2014年
4期
374-376,397
,共4页
曹树明%杨蓊勃%虞聪%宫可同
曹樹明%楊蓊勃%虞聰%宮可同
조수명%양옹발%우총%궁가동
磁共振成像%臂丛神经%诊断%损伤
磁共振成像%臂叢神經%診斷%損傷
자공진성상%비총신경%진단%손상
Magnetic Resonance Imaging%Brachial Plexus%Diagnosis%Injury
目的:探讨臂丛MRI在臂丛神经节前损伤诊断中的临床价值。方法45例临床诊断为臂丛神经损伤的患者,术前均采用1.5 T GE Signa EXCITE MRI扫描仪行双侧臂丛MRI扫描,同时所有患者均行锁骨上臂丛神经探查以及术中肌电图检查,将MRI扫描结果与手术所见及术中肌电图进行比较,分析臂丛MRI在节前损伤诊断中的准确率。结果45例共225根神经根,169根节前损伤,MRI共检出147根,MRI诊断总体准确率为86.2%,并且MRI检查距受伤时间与诊断准确率无明显相关性(P>0.05)。结论臂丛MRI可以清晰地显示臂丛神经椎管内外的结构,对臂丛神经节前损伤可以提供准确而清晰的定位定性诊断,具有非常高的准确率,可以为临床诊断提供可靠参考,指导临床早期制定手术方案,有益于患者的预后。
目的:探討臂叢MRI在臂叢神經節前損傷診斷中的臨床價值。方法45例臨床診斷為臂叢神經損傷的患者,術前均採用1.5 T GE Signa EXCITE MRI掃描儀行雙側臂叢MRI掃描,同時所有患者均行鎖骨上臂叢神經探查以及術中肌電圖檢查,將MRI掃描結果與手術所見及術中肌電圖進行比較,分析臂叢MRI在節前損傷診斷中的準確率。結果45例共225根神經根,169根節前損傷,MRI共檢齣147根,MRI診斷總體準確率為86.2%,併且MRI檢查距受傷時間與診斷準確率無明顯相關性(P>0.05)。結論臂叢MRI可以清晰地顯示臂叢神經椎管內外的結構,對臂叢神經節前損傷可以提供準確而清晰的定位定性診斷,具有非常高的準確率,可以為臨床診斷提供可靠參攷,指導臨床早期製定手術方案,有益于患者的預後。
목적:탐토비총MRI재비총신경절전손상진단중적림상개치。방법45례림상진단위비총신경손상적환자,술전균채용1.5 T GE Signa EXCITE MRI소묘의행쌍측비총MRI소묘,동시소유환자균행쇄골상비총신경탐사이급술중기전도검사,장MRI소묘결과여수술소견급술중기전도진행비교,분석비총MRI재절전손상진단중적준학솔。결과45례공225근신경근,169근절전손상,MRI공검출147근,MRI진단총체준학솔위86.2%,병차MRI검사거수상시간여진단준학솔무명현상관성(P>0.05)。결론비총MRI가이청석지현시비총신경추관내외적결구,대비총신경절전손상가이제공준학이청석적정위정성진단,구유비상고적준학솔,가이위림상진단제공가고삼고,지도림상조기제정수술방안,유익우환자적예후。
Objective To evaluate magnetic resonance imaging in diagnosing brachial plexus preganglionic injury and to investigate the value of MRI in clinical application. Methods 45 patients who were presented with brachial plexus injuries underwent MRI scanning with several sequences before operation. MRI imaging was obtained by GE Signa EXCITE1.5 T scanner. All of patients had carried out exploration of the supraclavicular plexus and intraoperative electromyogram. Images of MRI were compaied with surgical findings and electromyogram diagnosis. To evaluate the value of diagnosis in brachial plexus preganglionic injury by MRI. Results There were 225 nerve roots in 45 patients. Among them 169 preganglionic injured roots, MRI imaging detected 147. The accuracy of MRI in diagnosing brachial plexus preganglionic injury were 86.2%. However there is not significant correlation between the accuracy of MRI examination and duration from the time of injury to the time of diagnosis (P>0.05). Conclusion MRI can distinctly manifest the nerves within and out of the vertebral canal, thus, can help making a correct diagnosis in brachial plexus preganglionic injury, MRI can help to formulate treatment protocols and improve the prognosis of the brachial plexus preganglionic injury.