臂丛MRI在臂丛神经节前损伤诊断中的临床效能分析  

Clinical effectiveness analysis of MRI in the diagnosis of brachial plexus preganglionic injury

作　　者：曹树明[1] 杨蓊勃[2] 虞聪[3] 宫可同[1] 

机构地区：[1]天津市天津医院手显微外科一病区,天津300211 [2]南京市第一医院手外科,江苏南京210006 [3]复旦大学附属华山医院手外科,上海200040

出　　处：《实用手外科杂志》2014年第4期374-376,397,共4页Journal of Practical Hand Surgery

摘　　要：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。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.

关 键 词：磁共振成像 臂丛神经 诊断 损伤 

分 类 号：R651.3[医药卫生—外科学]