臂丛及腰骶丛神经损伤及失神经支配骨骼肌的MRI表现  

MRI Appearance of Branchial Plexus and Lumbosacral Plexus Injury and Denervated Skeletal Muscles

作　　者：柳曦[1] 孔祥泉[1] 吕银章[1] 刘定西[1] 罗是是[1] 杨帆[1] 杨明[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉430022

出　　处：《临床放射学杂志》2012年第2期239-243,共5页Journal of Clinical Radiology

摘　　要：目的探讨臂丛及腰骶丛神经损伤的MRI表现及失神经支配骨骼肌形态及信号改变。资料与方法对21例经肌电图和临床证实的臂丛及腰骶丛神经损伤患者行常规MR序列扫描、三维短恢复时间反转恢复(3D-STIR)序列平扫及增强扫描,分析神经损伤及失神经支配肌肉组织改变的MRI表现。结果 3D-STIR序列能清晰显示臂丛及腰骶丛神经损伤的各种征象,包括创伤性脊膜囊肿、神经根撕脱、神经水肿、增粗神经迂曲、扭曲、神经干断裂等。失神经支配骨骼肌的MRI表现为不同序列上肌肉组织信号增高、肌肉萎缩和脂肪浸润,增强扫描罹患肌肉强化明显。失神经支配肌组织S患/S健与创伤时间呈负相关。结论 MRI上可以清晰显示臂丛及腰骶丛神经损伤情况和失神经支配肌肉形态和信号改变,为临床制定治疗方案提供依据。Objective To analyze the MR appearance of branchial plexus and lumbosacral plexus injury and denervated skeletal muscles after nerve injury.Materials and Methods Conventional sequence,3D-STIR plain and enhanced scan were carried out in 21 patients with branchial plxus and lumbosacral plxue injury proved by electramyogram and clinical data.MR features,including the nerve injury,shape and signal changed of the denervated skeletal muscle were investigated.Results The direct sign of branchial plexus and lumbocacral plexus injury,including posttraumatic spinal meningocele,mutilation of the root or stem of nerve,coarsening,bending and swelling of the nerve stem,could be displayed clearly on 3D-STIR plain and enhanced images.The MR features of denervated skeletal muscle comprehend hyperintensity on various sequences with atrophy,and enhanced intensely.The area ratio of denervaed and normal muscle was decayed with time and the ratio had negnative correlation with time.Conclusion MR is a useful method in monitoring nerve injury and the hypotrophy degree of denervated skeletal muscle,which can provide evidence for clinical therapy.

关 键 词：神经损伤 失神经支配肌肉 磁共振成像 臂丛 腰骶丛 

分 类 号：R445.2[医药卫生—影像医学与核医学]