脊髓造影CT诊断臂丛神经节前损伤

CT Myelography Diagnosis of Brachial Plexus Pre-ganglionic Injury

目的 探讨脊髓造影CT诊断臂丛神经节前损伤的影像表现及其诊断价值。资料与方法 对 18例臂丛神经损伤患者作常规腰穿脊髓造影 ,而后采用高分辨率CT薄层扫描。全部患者以手术探查所见和电生理学检查结果作为标准。结果 臂丛神经节前损伤的主要征象是神经根缺失及走行异常 ;创伤性脊膜囊肿 ;脊髓移位 ;脊髓变形与“黑线征”。本组共检出 33个受损神经根 ,其诊断的敏感性、特异性及准确性分别为 93.9%、75 .0 %及90 .2 %。结论 脊髓造影CT可以显示椎间孔周围神经根的情况 ,对臂丛神经节前损伤的定性定位可做出准确判断。

Objective To evaluate CT myelography (CTM) in diagnosing brachial plexus pre-ganglionic injury.Materials and Methods Eighteen cases with brachial plexus injury underwent thin-slice HRCT scanning after the examination of conventional lumbar puncture myelography. CT findings were compared with surgical and somatoevoken potential results, which were used as the standards. Results The main signs of brachial plexus pre-ganglionic injury were lack of nerve root, post-traumatic spinal meningocele, displacement and deformity of spinal cord, and 'black line' sign. CTM detected 33 injured nerve rootlets. The sensitivity, specificity and accuracy of CTM in diagnosing pre-ganglionic brachial plexus were 93.9%, 75.0% and 90.2%, respectively.Conclusion CT Myelography can show the nerve rootlets within the intervertebral foramen, thus, help make a correct qualitative and level diagnosis in brachial plexus pre-ganglionic injuries.