弥散加权神经成像术诊断臂丛神经病变

Diffusion weighted magnetic resonance neurography in brachial plexus neuropathy

目的探讨弥散加权神经成像术(DW-MRN)对臂丛神经病变诊断的准确性及定量诊断价值。方法对52例受检者行常规MR序列及重T2脂肪抑制(T2WI/SPIR)和DW-MRN。其中20例臂丛神经病变患者按病理类型分为损伤组、炎症组和肿瘤组。结果与T2WI/SPIR比较,DW-MRN臂丛C7神经节的对比噪声比和病灶对比噪声比均较高(t=2.19、3.91,P均<0.05),对臂丛神经病变诊断的灵敏度亦较高(χ2=4.44,P<0.05)。臂丛神经病变的ADC值高于正常神经节和中干(t=4.80、5.69,P均<0.05);损伤组和肿瘤组的ADC值高于炎症组(F=6.99、5.28,P均<0.05)。结论DW-MRN对臂丛神经及其病变有良好的显示能力,ADC值可作为臂丛神经病变的定量诊断的参考指标。

Objective To evaluate the accuracy and quantitative diagnostic value of diffusion weighted MR neurography（DW-MRN）in brachial plexus neuropathy.Methods Twenty patients with brachial plexus diseases and 32 controls underwent cervix MR scan included heavy-T2WI with fat-suppress（T2WI/SPIR）and DW-MRN.The patients were divided into 3 groups,i.e.injury group,inflammation group and tumor group.Results Contrast-to-noise ratio（CNR）of C7 and the lesions with DW-MRN were higher than those with T2WI/SPIR（t=2.19,3.91,both P0.05）.The diagnostic sensitivity of DW-MRN in brachial plexus neuropathy was higher than that of T2WI/SPIR（χ 2=4.44,P〈0.05）.The ADC value of brachial plexus focus was higher than that of normal ganglion and middle trunk（t=4.80,5.69,both P〈0.05）.The ADC value of injury group and tumor group was higher than that of inflammation group（F=6.99,5.28,both P〈0.05）.Conclusion DW-MRN has great value in detecting brachial plexus neuropathy,and the ADC value can be used as index of quantitative diagnosis.