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Evaluation of brachial plexus injury by MRI
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 6
- DOI:
- 10.3760/j.issn:1005-1201.2007.06.002
- Key Word:
- 臂丛;神经根病;磁共振成像
Abstract： 目的 评价MRI诊断臂丛神经损伤的临床价值.方法 98例临床诊断臂丛神经损伤的患者在手术前行MR检查,其中54例采用Philip Gyroscan T5-Ⅱ型0.5 T超导MR仪,44例采用Philip Intera 1.5 T超导MR仪.采用头颈联合线圈或颈部阵列线圈,行横断和冠状面扫描.扫描序列为SE T1WI、T2WI和快速梯度回波(FFE)序列T2WI、T2WI反转恢复(SPIR)压脂序列.98例中63例行锁骨上手术探查,将术中发现与MRI结果比较;35例未手术的患者经临床随访证实.结果 MRI显示椎管内损伤45例,椎管外损伤56例,其中椎管内外混合性损伤16例,未发现损伤征象13例,阳性率86.73%.节前损伤的征象包括:(1)脊髓水肿和出血2例(4.44%);(2)脊髓移位17例(37.78%);(3)创伤性脊膜囊肿37例(82.22%);(4)神经根缺失25例(55.56%);(5)椎管内瘢痕24例(53.33%);(6)失神经肌肉萎缩和脂肪浸润13例(28.89%).节后损伤的征象包括:(1)神经干增粗、信号增高23例(41.07%);(2)神经干连续性中断,结构消失16例(28.57%);(3)神经干连续性存在,但结构紊乱14例(25.00%);(4)创伤性神经纤维瘤形成3例(5.36%).结论 MRI能够同时显示臂丛节前和节后神经损伤,对鉴别节前损伤、节后损伤、损伤类型,以及确定治疗方案和选择治疗时机均具有重要的临床应用价值.
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