椎管内臂丛神经根损伤及损伤类型MRI诊断价值研究

The diagnostic value of MRI on the intraspinal brachial plexus nerve root injury and the injury trypes

目的将MRI与CTM进行对比,探讨Balance SSFP序列在臂丛椎管内神经根损伤及损伤类型诊断中的临床应用价值。方法可疑椎管内臂丛神经根损伤的病例中挑选符合条件315例进行MRI与CTM对比分析,其中297例行常规锁骨上探查臂丛神经根。结果 315例有疑患侧神经根1575个,MRI诊断椎管内神经根损伤的灵敏度为84.35%,特异度为95.79%,总符率为89.13%。部分型中单纯前根或后根完全撕脱73个,前根和/或后根部分撕脱的有63个神经根,MRI仅诊断出108个,符合率为79.41%,CTM显示神经根断裂型损伤43个,MRI诊断31个,符合率为72.09%。结论 MRI-Balance SSFP序列作为无创性检查在臂丛神经根损伤的患者中起到重要作用并可作为首选筛查诊断方法。

Objective The comparison of MRI and CTM to investigate the clinical application value was based on the di- agnosis of the Balance SSFP Sequence from the intraspinal brachial plexus nerve root injury and the injury types. Methods We selected 315 qualified cases among the suspicious intraspinal brachial plexus nerve root injury to make a comparison be- tween MRI and CTM, of which 297 cases were probed the brachial plexus nerve roots from the conventional collarbone. Results A total of 315 cases were found to be suspected to have 1,575 ipsilateral nerve roots, the sensitivity by MRI was 84.35% of the intraspinal brachial plexus nerve root injury, the specificity was 95.79%, the total rate was 89.13%. The number of complete avulsion of some kind of nerve roots from the front part or back part was 73, and 63 nerve roots were in avulsion partly from front nerve root and/or back roots. MRI only diagnosed 108, and the qualified rate was 79.41%. CTM displayed 43-nerve root fracture types of injury. MRI diagnosed 31 and the rate was 72.09%. Conclusion MRI-Bal- ance SSFP Sequence as a noninvasive method plays an important role in patients with brachial plexus nerve root injury and can be used as the preferred screening and diagnostic method.