高分辨率磁共振成像对臂丛神经损伤的预测价值  

The predictive value of high-resolution magnetic resonance imaging for brachial plexus injury

作　　者：蔡剡军[1] 王国松[1] 江茜[1] 黄锦金 Cai Shanjun;Wang Guosong;Jiang Qian;Huang Jinjin(Department of Radiology,Shaoxing Traditional Chinese Medicine Hospital,Shaoxing,Zhejiang 312000,China)

机构地区：[1]绍兴市中医院放射科,浙江绍兴312000

出　　处：《中国微侵袭神经外科杂志》2024年第4期226-231,共6页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：绍兴市级医卫类科技计划项目立项(编号:2020A13044)。

摘　　要：目的探析高分辨率磁共振(MRI)成像对臂丛神经损伤(brachial plexus injury,BPI)的预测价值。方法对59例临床拟诊BPI的病例行高分辨MRI检查。根据年龄,将年龄≥65岁者纳入老年组,18~64岁者纳入青中年组。观察两组臂丛神经显像效果,计算臂丛神经成像评分、臂丛神经信噪比(signal-to-noise ratio,SNR)、对比度噪声比(contrast-to-noise ratio,CNR)和背景抑制评分,分析高分辨率MRI成像对不同年龄段BPI的预测价值。结果59例临床拟诊BPI病例中,MRI诊断为BPI 20例,其余正常。20例经MRI确诊BPI中,老年组7例和青中年组13例。老年组节前损伤2例(28.57%),节后损伤5例(71.43%);青中年组节前损伤5例(38.46%),节后损伤8例(61.54%)。两组病人臂丛神经成像评分由低到高依次为三维双回波稳态(3D-DESS)序列增强扫描、三维短时反转恢复快速自旋回波(3D SPACE)序列平扫、DESS序列平扫和SPACE序列增强扫描,且在干3、支5 DESS序列平扫、股6 DESS序列增强扫描及支5 SPACE序列增强扫描上,老年组臂丛神经成像评分明显低于青中年组(P<0.05)。两组SNR、CNR由低到高依次为DESS增强、SPACE平扫、DESS平扫和SPACE增强(P<0.05),两组背景组织抑制评分比较,SPACE增强最高,其次为DESS平扫,DESS增强和SPACE平扫最低(P<0.05)。老年组DESS序列增强扫描的SNR、CNR以及SPACE序列平扫、增强扫描的SNR、CNR均明显低于青中年组(P<0.05)。结论与青中年BPI病人相比,老年BPI病人臂丛神经成像评分、SNR与CNR更低,MRI 3D SPACE序列可清晰显示臂丛神经内部信号改变,同时降低神经周围背景组织信号干扰,对于显示神经损伤优势明显,值得临床优先选择。Objective To explore the predictive value of high-resolution magnetic resonance imaging(MRI)for brachial plexus injury(BPI).Methods A total of 59 clinically suspected cases of BPI were evaluated using high-resolution MRI.These patients were divided into two groups based on age:individuals aged≥65 years were included in the elderly group,while those aged between 18 and 64 years were included in the middle-aged group.The imaging effects of the brachial plexus nerves in the two groups were observed,and the brachial plexus nerve imaging score,brachial plexus signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),and background tissue inhibition scores were calculated.The predictive value of high-resolution MRI imaging for BPI in different age groups was analyzed.Results Among 59 clinically suspected cases of BPI,20 were diagnosed as BPI by MRI,while the remaining cases were normal.Among the 20 patients with BPI by MRI,there were 7 in the elderly group and 13 in the middle-aged group.In the elderly group,there were 2 cases(28.57%)of pre-ganglionic injury and 5(71.43%)of post-ganglionic injury.In the middle-aged group,there were 5(38.46%)of pre-ganglionic injury and 8(61.54%)of post-ganglionic injury.The brachial plexus imaging scores in the two groups of patients,from low to high,were sequentially 3D dual echo steady-state(3D-DESS)sequence enhanced scan,and 3D short time reversal recovery fast spin echo(3D SPACE)sequence plain scan,DESS sequence plain scan,and SPACE sequence enhanced scan.Moreover,on the trunk 3,branch 5 DESS sequence plain scan,branch 6 DESS sequence enhanced scan,and branch 5 SPACE sequence enhanced scan,the brachial plexus imaging score of the elderly group was significantly lower than that of the middle-aged group(P<0.05).The SNR and CNR of the two groups of brachial plexus nerves,from low to high,were in descending order:DESS enhancement,SPACE plain scan,DESS plain scan,and SPACE enhancement(P<0.05).In terms of comparison of the background tissue inhibition scores in the two groups,SPACE enhan

关 键 词：臂丛神经损伤 三维短时反转恢复快速自旋回波序列 磁共振成像 

分 类 号：R745[医药卫生—神经病学与精神病学]