磁共振成像技术在臂丛神经损伤中的临床应用

The clinical application of MRI technology in diagnosing brachial plexus injury

目的探讨磁共振常规扫描序列结合磁共振神经成像术(magnetic resonance neurography,MRN)在臂丛神经损伤诊断中的应用价值。方法对20例正常志愿者及11例臂丛神经损伤患者行双侧臂丛神经成像,包括常规快速自旋回波序列T1加权(T1W/TSE)横轴位、快速自旋回波序列T2加权(T2W/TSE)横轴位及斜冠状位、重T2WI反转恢复脂肪抑制技术成像序列(STIR/long TE)冠状位以及弥散加权背景抑制成像序列(DWIBS)轴位扫描。结果轴位T1WI、T2WI与斜冠状位T2WI在显示臂丛神经椎管内段与椎间孔段较好,STIR/long TE及DWIBS在显示臂丛神经干具有较大优势。臂丛节前神经损伤病变在T2WI横轴位与斜冠状位显示较好,T1WI可较特异显示脊髓内或局部软组织内出血或血肿信号。节后神经损伤则以冠状位STIR/long TE及DWIBS序列对病变的显示效果好,能显示神经干增粗或信号异常,对神经损伤定位准确。结论磁共振常规扫描序列结合磁共振神经成像术,在臂丛神经损伤的定位定性诊断具有广阔的应用前景。

Objective To discuss the application of MRI conventional technology combined with magnetic resonance neurography in displaying the brachial plexus （bp） injury. Methods Twenty volunteers and 11 patients with BP diseases underwent conventional sequences ima- ging（ axial T1WI and T2WI） , oblique coronal T2WI, coronal STIR/long TE and axial DWIBS on 3.0T. Results The brachial plexus segments of intra-spinal cord and intervertebral fora- men were displayed better with axial T1WI and T2WI and oblique was displayed better with STIR/long TE and DWIBS. Pregangli coronal T2WI. The bp trunk onic nerve injury of brachial plexus lesion on T2WI axial and oblique coronal showed better. TIWI was a specific display within the spinal cord or local soft tissue hemorrhage or hematoma signal. Coronal STIR/long TE and DWIBS sequence showed a good effect in the displaying postganglionic nerve injury, for it showed neural stem thickening or signal abnormalities of nerve injury in order to figure out the accurate positon. Conclusion MRI conventional technology magnetic resonance neurography will be very helpful for the location diagnosis and the determination of the degree of injury in the brachial plexus.