摘要
目的:探讨臂丛神经损伤的MRI表现、分型及应用价值。方法:70例臂丛损伤患者(59例手术,11例经临床随访)术前行MR检查,将术中所见、肌电图及随访结果与MRI结果比较。结果:47例节前损伤患者的196对受损神经根中MR检出176对,准确度、敏感度及特异度为89.1%、89.8%、84.8%。节前损伤征象:①椎管内神经根消失161对;②前后根增粗、僵硬,无法连续追踪至椎间孔处20对;③椎管内脑脊液囊性聚集,假性脊膜膨出96对;④神经根袖形态异常54对;⑤脊髓变形移位79节段;⑥椎间孔区瘢痕形成11对;⑦脊髓损伤5例;⑧椎旁肌肉信号异常42例。节后损伤表现:①神经走行自然,结构及信号与健侧一致2例;②神经连续、走行自然、增粗、信号增高18例;③神经连续、走行僵硬、结构紊乱19例;④神经断裂,断端分离2例;⑤神经断裂,断端假性神经瘤形成2例。臂丛损伤M R表现分型:正常表现型、神经变性水肿型、神经瘢痕纤维化型、神经断裂型、神经根性撕脱伤、混合型。结论:MRI能对臂丛损伤做出准确的诊断,对患者手术方案的制定和预后改善有重要价值。
Purpose：To evaluate MR performance and application in diagnosis and classification of brachial plexus injury.Methods：Seventy cases of brachial plexus injury patients（operation was undertaken in 59 and followed - up exam without operation was done in 11） underwent MR scanning before operation.MR results were compared with the operation findings,electromyogram and following up results. Results：Of these 196 pairs of injured roots,MRI detected 176 pairs.The accuracy,sensitivity and specificity of MRI in diagnosing preganglionic brachial plexus injury were 89.1%,89.8%and 84.8%, respectively.The signs of preganglionic injury include：①lack or mutilation of nerve root,161 pairs;②coarsening,stiff and can not be traced to the intervertebral foramen continuously,20 pairs;③cystoid cerebrospinal fluid concentrating in vertebral canal,posttraumatic spinal meningocele,96 pairs;④abnormal shape of nerve sleeve,54 pairs;⑤displacement and deformity of spinal cord,79 segments;⑥fibrae scar in intervertebral foramen region,11 pairs;⑦spinal cord injury,5 patients;⑧abnormal signal of paraspinal muscles,42 patients.The signs of postganglionic injury include：①natural courser of the nerve,the same structure and signal intensity with normal side,2 cases;②thickening of the nerve,with continuity and natural courser,and increased intensity,18 cases;③thickening of the nerve,with continuity and stiff courser,19 cases;④losing of continuity completely,with isolated broken ends,2 cases;⑤traumatic nerofibroma,2 cases.The MRI performances of brachial plexus injury contained 6 subtypes： normal appearance,neural degeneration and edema,neural scarification and fibrosis,neurotmesis,root avulsion and the mixed type.Conclusion：MRI can help making a correct diagnosis in brachial plexus injuries,and is important for making treatment plan and improving the prognosis.
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2011年第6期513-516,共4页
Chinese Computed Medical Imaging
关键词
臂丛神经损伤
磁共振成像
诊断
分型
Brachial plexus injury
Magnetic resonance imaging
Diagnosis
Classification
作者简介
通信作者：耿道颖（电子邮箱：gengdy@163．com）
