3.0T MRI在臂丛神经疾病诊断中的价值

3.0T MRI diagnosis of brachial plexopathies

目的:探讨3.0T MRI对臂丛神经疾病的临床应用价值。方法:使用GE signa HDx 3.0T超导磁共振仪,GEADW 4.3工作站进行图像后处理,磁共振脉冲序列:常规序列、三维超快速稳态进动成像序列(3D-FIESTA-c)及短时反转恢复脉冲序列(STIR),对20例临床怀疑臂丛神经受累的患者行磁共振检查。将所得数据进行图像后处理,分析臂丛神经疾病的影像学特点及MRI对臂丛病变的诊断价值。结果:20例怀疑臂丛神经受累的患者中,创伤性臂丛神经损伤13例,其主要征象包括:正常神经根消失或离断、连续性中断,创伤性脊膜囊肿、"黑线征",神经根袖形态失常;神经根增粗。7例非创伤性病变,分别为1例神经纤维瘤病(Ⅱ型),2例臂丛神经鞘瘤,1例神经纤维瘤,1例脊膜瘤,1例囊肿,1例神经根鞘囊肿,STIR序列能够清晰显示病变的位置及与神经的关系。结论:磁共振可以清晰地显示臂丛神经的节前纤维、节后纤维的解剖结构,并对累及臂丛神经的疾病作出比较准确的诊断,是诊断臂丛神经疾病的一种无创、有效的影像学检查方法。

Objective：To evaluate the clinical application of 3.0T MR imaging on diagnosis of brachial plexopathies. Methods： Twenty cases with brachial plexopathies underwent MR scanning. MR imaging was obtained by GE signa HDx 3.0T scanner, GE ADW 4.3 workstation for image post processing. The scanning sequences included：conventional sequence,3D fast imaging employing steady state with phase cycled （3D-FIESTA-c） and short inversion recovery pulse sequence （STIR）. After the obtained image data processing,to analyze the characteristics of braehial plexopathies and MRI imaging diagnosis of the brachial plexopathies. Results：Twenty cases of suspected brachial plexopathies were included, traumatic brachial plexus injury（ 13 cases） .mainly showing as follows： lack or mutilation of nerve root, continuous interruption, pseudomeningocele, black line sign, abnormal shape of nerve sleeve,nerve root coarsening; non-traumatic brachial plexus injury （7 cases）,including 1 case of neurofibromatosis （ Ⅱ type） .2 cases of brachial plexus nerve sheath tumor, 1 case of neurofibroma, 1 meningioma, 1 cyst, l case of nerve root sheath cyst. SIRT sequence could clearly show the location of lesions and its relationship with nerve. Conclusion： MRI can clearly show preganglionic fibers of brachial plexus, postganglionic fibers,and make a accurate diagnosis of brachial plexus trauma injury and non-traumatic brachial plexopathies. It is a non invasive,effective imaging method for the diagnosis of brachial plcxopathies.