增强磁共振神经成像显示正常腕掌部正中神经、尺神经及分支的价值  

The Value of Contrast-Enhanced Magnetic Resonance Neurography in Displaying the Normal Median Nerve, Ulnar Nerve and Branches of Wrist and Palm

作　　者：康佳敏 吴文骏 郑传胜[1,2] 孔祥闯[1,2] 刘定西[1,2] 刘小明 王莉霞[1,2] KANG Jiamin;WU Wenjun;ZHENG Chuansheng(Department of Radiology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei Province 430022,P.R.China)

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 [2]华中科技大学同济医学院附属协和医院分子影像湖北省重点实验室,武汉430022

出　　处：《临床放射学杂志》2022年第9期1631-1635,共5页Journal of Clinical Radiology

基　　金：湖北省自然科学基金(编号:2017CFB708);华中科技大学自主创新研究基金(编号:2016YXMS234);华中科技大学同济医学院附属协和医院科学研究基金(编号:02.03.2018-224、02.03.2019-131、F016.02004.21003.103)资助项目。

摘　　要：目的 探讨增强磁共振神经成像(ceMRN)显示腕掌部正中神经、尺神经及分支的价值。方法 前瞻性搜集34例健康志愿者,进行右侧手腕平扫3D SPACE-STIR序列神经成像(cMRN)及增强3D SPACE-STIR序列ceMRN扫描,观察正常正中神经、尺神经及分支的形态及信号特征,测量豆状骨及钩骨层面正中神经、第一掌骨骨髓、肌腱、大鱼际肌、皮下脂肪、小血管的信噪比(SNR)及背景噪声的标准差(σ0),并计算正中神经相对其他组织的对比噪声比(CNR)及对比度(CR),比较cMRN和ceMRN的图像质量。结果 cMRN图像中神经、骨髓、肌腱、肌肉、皮下脂肪、血管的SNR均高于ceMRN图像所得(P<0.05);ceMRN图像中豆状骨层面正中神经-皮下脂肪、神经-血管CR显著高于cMRN图像所得(P<0.001,P<0.001);ceMRN图像中钩骨层面正中神经-皮下脂肪、神经-血管CR显著高于cMRN图像所得(P<0.05,P<0.001);ceMRN图像中豆骨及钩骨层面正中神经-血管CNR显著高于cMRN图像所得(P<0.001)。结论 ceMRN能显著抑制神经伴行血管的信号,提升腕掌部正中神经、尺神经及分支的图像质量,实现腕掌部神经的三维高分辨率成像。Objective To explore the value of contrast enhanced Magnetic Resonance Neurography(ceMRN) in displaying the median nerve, ulnar nerve, and branches of wrist and palm. Methods Thirty-four healthy volunteers were prospectively enrolled for plain 3 D SPACE STIR sequence(conventional Magnetic Resonance Neurography, cMRN) and contrast enhanced 3 D SPACE STIR sequence(ceMRN) scanning of the right wrist.The morphology and signal characteristics of the normal median nerve, ulnar nerve and branches were observed.The signal to noise ratio(SNR) of the median nerve at the level of pisiform and hamate bone, the bone marrow of the first metacarpal bone, tendon, thenar muscles, subcutaneous fat, small blood vessel and the standard deviation(σ0) of background noise were measured.The contrast to noise ratio(CNR) and contrast ratio(CR) were calculated.The imaging quality of cMRN and ceMRN were compared. Results The SNRs of nerve, bone marrow, tendon, muscles, subcutaneous fat and blood vessel in the cMRN image were higher than those in the cMRN image(P<0.05);The CR(nerve subcutaneous fat) and CR(nerve vessel) at the level of pisiform bone in the ceMRN image were significantly higher than those in the cMRN image(P<0.001,P<0.001);The CR(nerve subcutaneous fat) and CR(nerve vessel) at the level of hamate bone in the ceMRN image were significantly higher than those in cMRN images(P<0.05,P<0.001);The CNR(nerve vessel) at the level of pisiform bone and hamate bone in the ceMRN image were significantly higher than those in the cMRN image(P<0.001). Conclusion ceMRN can significantly suppress the signal of blood vessel, improve the image quality of the median nerve, ulnar nerve and branches of the wrist and palm, and achieve three dimensional high resolution images of the wrist and palm nerves.

关 键 词：磁共振成像 增强磁共振神经成像 正中神经 尺神经 

分 类 号：R445.2[医药卫生—影像医学与核医学]