3D-STIR序列对比增强扫描在新生儿臂丛神经麻痹中的应用

Application of contrast enhanced 3D-stir sequence scanning in evaluation of neonatal brachial plexus palsy

目的探讨三维短恢复时间反转恢复重T2加权成像(3D-STIR-SPACE-T2WI)序列对比增强扫描在新生儿臂丛神经成像中的可行性,评价其在新生儿臂丛神经麻痹中的效果和价值。方法回顾性研究2017年6月至2018年12月期间郑州大学第三附属医院收治的22例出生后发现单侧上肢活动异常的新生儿(其中男12例,女10例),年龄2~28 d,平均(12.05±8.052)d。所有患儿均行常规序列、3D-STIR-SPACE-T2WI序列平扫及3D-STIR-SPACE-T2WI序列增强扫描,评价神经显示情况和对比图像噪声比,并与健侧对比。结果3D-STIR序列增强扫描对患儿健侧及损伤侧的臂丛神经各解剖段显示评分及综合评分明显优于平扫序列,差异具有显著的统计学意义(P<0.001)。结论3D-STIR序列增强扫描对臂丛神经的解剖结构显示更加清楚,在新生儿臂丛神经麻痹的定性及定位诊断、损伤程度的判定方面有广阔的应用前景。

Objective To investigate the value of contrast enhanced three-dimensional short time inversion recovery(3D-STIR)sequence in detection of neonatal brachial plexus palsy(NBPP)using sampling perfection with application optimized contrasts using different flip angle evolution(SPACE)sequences.Methods A retrospective study was conducted on 22 newborn infants(12 males and 10 females)with brachial plexus palsy secondary to traumatic delivery,aged from 2 days to 28 days,with an average of(12.05±8.052)days.All the infants were underwent MR imaging of conventional 2D turbo-spin echo T2-weighted images(2D-TSE-T2WI),three-dimensional short time inversion recovery T2-weighted imaging(3D-STIR-T2WI)SPACE sequences(3D-STIR-SPACE-T2WI),and contrast enhanced 3D-STIR-SPACE-T2WI sequence.The findings and noise ratio of images were evaluated and compared between two sides.Results Compared with plain images,contrast enhanced 3D-STIR sequence showed statistically significant differences in the scores of all anatomical segments of the brachial plexus in both injuried sides and uninjuried sides(P<0.001),and the contrast enhancement images were significantly greater than the plain images.Conclusion Contrast enhanced 3D-STIR sequence can show the anatomy of the neonatal brachial plexus clearly.It is promising for the location diagnosis and determine the degree of injury in the neonatal brachial plexus palsy.