高频超声对臂丛神经显像和定位的价值

Value of high-resolution sonography mapping and locating the banchial plexus

目的评价高频超声对臂丛神经显像和定位的价值。方法采用高频超声对30例志愿者行臂丛神经检查,主要在肌间沟、锁骨上、锁骨下及腋下4个部位。11例志愿者臂丛分布的4个部位上,在实时超声引导下进针及定位神经,然后在电神经器刺激下确认是否为神经。所有臂丛神经声像图特征、解剖的变化、进针和神经定位均被动态记录。结果臂丛神经在横断面上表现为圆形或椭圆形的低回声结构,内部由点状回声组成,肌间沟、锁骨上及腋下臂丛神经显示率均为100%,锁骨下臂丛神经显示率为97%。11例志愿者臂丛声像图上低回声结构在超声引导下行电刺激均被证实为神经组织。结论高频超声能提供高质量的臂丛神经声像图。超声引导下穿刺对臂丛神经阻滞麻醉有潜在应用价值。

Objective To demonstrate the images of the brachial plexus and locate by means of high-resolution sonography. Methods Thirty volunteers underwent brachial plexus examination using an L10-14 MHz probe in the interscalene, supraclavicular, infraclavicular, and axillary regions. Thereafter, an block needle was advanced under direct ultrasound guidance to target nerves before confirmation by electrical nerve stimulation in eleven volunteers in each region. The quality of brachial plexus images, anatomic variations, and the needle advancement for nerve localization were dynamic recorded. Results The brachial plexus were successfully identified in the transverse view as round to oval hypoechoic structures with small internal punctuate echoes in all regions examined without one case in infraclavicular region. Hypoechoic structures were stimulated electrically and confirmed to be nerves by ultrasonic monitoring. Conclusions The high-resolution sonography can provide good quality brachial plexus ultrasound images. The needle technique for ultrasound-assisted nerve localization provides real-time guidance and is potentially valuable for brachial plexus blocks.