摘要
目的分析臂丛神经节后损伤的MR重T2加权神经成像术(MRN)表现,并与手术所见进行对照,评价其对臂丛神经节后损伤的应用价值。资料与方法 27例经手术确诊的臂丛神经节后损伤患者,术前分别对臂丛行常规T1WI、T2WI及重T2加权MRN检查,回顾性分析患者的MRI及手术资料,观察神经损伤情况。结果 27例重T2加权MRN共显示162条臂丛神经干,经手术证实受损神经干77条,其损伤征象:32条神经连续,但增粗、边缘模糊、信号升高;24条神经连续,但走行纡曲或僵硬、粘连、信号不均、结构不清;13条神经完全离断,正常信号消失,断端退缩;5条伴创伤性神经纤维瘤形成。MR重T2WI加权像诊断臂丛神经损伤条数与手术结果的符合率为80.5%(62/77)。臂丛神经根、干、束可为多支受累,上述表现可混合存在。结合常规MRI,10例伴节前损伤,征象包括脊髓内异常信号2例、脊髓移位3例、神经根缺失6例、椎管内瘢痕形成2例、创伤性脊膜囊肿6例、肌肉改变6例。结论 MR重T2加权MRN可以对大多数臂丛神经节后损伤做出正确诊断,可以作为臂丛神经检查的常规成像序列,结合常规序列能够做出节前损伤的诊断。
Purpose To evaluate heavily T2-weighted magnetic resonance neurography （MRN） in the diagnosis of postganglionic brachial plexus injury by comparing MRN findings with surgical results. Materials and Methods Twenty seven patients with postganglionie brachial plexus injury confirmed surgically underwent conventional T1WI, T2WI and heavily T2-weighted MRN before operations. The MRI data and surgical data were analyzed retrospectively to observe nerve injury. Rosults The heavily T2-weighted MRN images displayed 162 trunks of brachial plexus, of which 77 were confirmed injury by operation. The MRI findings were as follows： 32 trunks involved continuous nerves, but with thickening and blurred margin, as well as abnormal high signal intensity; 24 trunks were continuous, but with distortion, stiffness and adhesion accompanied by heterogeneous signal intensity and structural disorder; 13 trunks showed complete loss of continuity, absence of normal signal, accompanied by retraction; and 5 trunks involved formation of traumatic neurofibroma. The coincidence of injured nerve trunks diagnosed by MRN with surgical findings amounts to 80.5% （62/77）. Nerve roots, trunks and cords of brachial plexus might undergo mixed involvement. The conventional MRI showed ten cases with preganglionic injury, which involved signs of abnormal signal intensity in spinal cord in two cases, displacement of spinal cord in three cases, disappearance of nerve roots in six cases in spinal canal, scarring in two cases, traumatic meningoceles in six cases and changes of affiliated muscles in six cases. Conclusion MR with heavily T2-weighted imaging is effective in the diagnosis and depiction ofbrachial plexus postganglionic injury, therefore it can be used as conventional sequence in brachial plexus examination to detect brachial plexus preganglionic injury with the help of other conventional MRI sequences.
出处
《中国医学影像学杂志》
CSCD
北大核心
2014年第5期354-357,共4页
Chinese Journal of Medical Imaging
关键词
臂丛神经病
创伤
神经系统
磁共振成像
Brachial plexus neuropathies
Trauma, nervous system
Magnetic resonanceimaging
作者简介
通讯作者谢立旗
