肌电图与MRI检查结合诊断臂丛神经损伤的研究

A STUDY OF ELECTROMYOGRAPHY AND MRI IN DIAGNOSIS OF BRACHIAL PLEXUS INJURY

目的:评价肌电图和MRI检查以及两者结合在臂丛神经损伤诊断治疗中的价值。方法:对27例臂丛神经损伤患进行术前肌电图、MRI和术中肌电图检查,并与手术探查中的发现进行比较;比较术前肌电图与MRI检查同术中体感诱发电位(SEP)在确定神经完全性损伤中的作用。结果:术前肌电图检查对臂丛损伤定性、定位诊断的完全符合率为70.37％,符合率为96.3％;术前肌电圈和MRI检查对臂丛神经根撕脱诊断的符合率分别为55.56％和68.52％,术前肌电图检查和MRI检查结合可提高诊断符合率至85.19％;SEP对完全性臂丛损伤的诊断率高于肌电图和MRI,但差异无显著性。结论:肌电图检查和MRI检查可明显提高完全和基本符合率,是一种有前途的辅助诊断、指导治疗臂丛神经损伤的途径,术中进行SEP检查更加有利于手术方式的选择。

Objectives:To evaluate the value of electromyography(EMG) ,MRI and the combination of the two in diagnosis of brachial plexus injury. Methods: EMG and MRI of 27 cases were examined before operation and some of the cases were examined with EMG during the process of operation. The results were compared with the findings in operation. And the usefulness of EMG ,MRI in diagnosis of completely injury of brachial plexus injury before operation was valued and compare with that of somatosensory evoked potential (SEP)during operation. Results:EMG before surgery can diagnose brachial plexusimur with total accurate ratio of 70. 37% and partial accurate ratio of 96.3%. The ratio of EMG and MRI in diagnosis of tearing of nerve roots of brachial plexus before surgery is 55. 56% and 68. 52% respectively, and the combination of the two can increase the ratio to 85. 19%. SEP has higher accurate ratio in diagnosis than EMG and MRI,but the difference between them has no significance. Conclusion : The combination of EMG and MRI can improve the diagnosis accurate ratio, is a promising method in auxiliary diagnosis and guiding treatment. SEP during operation is helpful in choosing ways of surgery.