磁共振神经成像对臂丛神经损伤的诊断效能及其与手术的一致性研究

Brachial Plexus Injury:The Diagnostic Accuracy of Magnetic Resonance Neurography and Its Consistency with Surgery

目的 探讨磁共振神经成像(MRN)在臂丛神经损伤(BPI)中的诊断效能并评估其与手术的一致性。方法 回顾性分析35例BPI患者的影像资料及手术记录,以手术探查结果为对照标准,将术前MRN检查所见与手术探查结果进行比较。建立基于MRN征象的分类方法,分析M RN与手术探查结果的一致性。结果 MRN对35例患者神经损伤的定位评估与手术分型具有很高的符合率(9 1.4%),两者一致率良好(82.9%)。MRN诊断BPI的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为92.7%、71.4%、90.3%、96.2%、55.6%。BPI的MRN分类与手术探查结果无明显差别,两者一致性良好(Kappa=0.743;Kappa=0.686)。结论 MRN能直观、准确地显示BPI的位置、形态及信号,MRN的神经分类方法与手术探查具有良好一致性,对BPI的诊断及治疗具有重要价值。

Objective To investigate the diagnostic efficacy of magnetic resonance neuroimaging(MRN) in brachial plexus injury(BPI) and evaluate its consistency with surgery.Methods The imaging data and operating records of 35 patients with BPI were reviewed retrospectively.The findings acquired at preoperative MRN were compared to those obtained at surgical exploration,with surgical exploration outcomes serving as the reference standard.Develop a categorization approach based on MRN signs and examine the consistency between MRN and surgical exploration findings.Results The positional assessment of nerve injury by MRN in 35 patients had a high concordance rate(91.4%) with surgical subtyping,and both concordance rates were good(82.9%).The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MRN for the diagnosis of BPI were 92.7%,71.4%,90.3%,96.2%,and 55.6%,respectively.MRN classification by BPI did not differ significantly from surgical exploration results,and both had good consistency(kappa=0.743;kappa=0.686).Conclusion MRN can intuitively and accurately show the location,morphology,and signal of BPI.The neural classification method of MRN has good consistency with surgical exploration and is valuable for the diagnosis and treatment of BPI.